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WHIRLYBIRDS REGISTRATION
Students must pre-register online or call the church
(641) 664-2240 by January, 8th 2024
Please remember to also submit a permission slip to the school.
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Indicates required field
Parent/Guardian Name
*
First
Last
Phone Number
*
Email
*
Emergency Contact
*
First
Last
Phone Number
*
Child's Name
*
First
Last
GRADE
*
Child's Name
*
First
Last
GRADE
*
Child's Name
*
First
Last
GRADE
*
CHILD'S Name
*
First
Last
GRADE
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Food Allergies, Restrictions, or Comments
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Please list any food allergies, activity restrictions, or other comments here...
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