Light & Nightlight Child Registration Form ('24-'25)

Sundays, 10:45-11:30 am; Wednesdays, 7-8 pm | Please fill out this form and click submit.
Please fill out a separate form for each child in your family.
Child Info

 
 
For example, 2/10/1996
Please select all that apply.
 
Please select one option.
Please select one option.
Please select one option.
 
Adult Info

 
 
 
 
An additional address can include a physical address (as opposed to a mailing address), or the address of your child's secondary home.
 
 
If you have multiple emails or phone numbers to use for regular communication, include a semicolon between them.
Participation Info

Please select one option.
 
Please select one option.
 
 
Media Release

Please select one option.

Description

Sundays, 10:45-11:30 am; Wednesdays, 7-8 pm
Please fill out this form and click submit.