Events Archive - Page 4 of 7 - Grace Gospel Church

Summer Adventure Registration Form

Child's Name*
First Last
Child's Date of Birth*
Month
Day
Year
Last Grade Completed*
Parent/Guardian Name*
First Last
Parent/Guardian Cell Phone*
Home Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Email
Enter Email Confirm Email
Emergency Contact Name*
First Last
Emergency Contact Phone*
Medical or other information we need to know about your child (Please include all allergies). If there are none please write N/A in the box below*
Dismissal Information - Who may pick up your child at the end of each night?*

Women’s Ministry Event – Continental Breakfast will be served. There is no cost for the event, but you must sign up by filling out form below, calling the office 631-289-5495 or email us at admin@gracegospelchurch.com – Seating is limited to 50

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Join us for dinner! Bring either a main dish, side dish or dessert to share.

GEMS

Summer Adventure Registration Form

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Sunday Family Dinner