EECSS 2025 Registration Form

Parent/Guardian *

Phone *

Address

Parent/Guardian

Phone

Address

Child 1 First and Last Name *

Birth date *

Gender

Male

Female

Allergies (food,latex,bee stings etc, things one might come in contact with at church)

Child 2 First and Last Name

Birth date

Gender

Male

Female

Allergies (food,latex,bee stings etc, things one might come in contact with at church)

Child 3 First and Last Name

Birth date

Gender

Male

Female

Allergies (food,latex,bee stings etc, things one might come in contact with at church)

Child 4 First and Last Name

Birth date

Gender

Male

Female

Allergies (food,latex,bee stings etc, things one might come in contact with at church)

I give my permission to have my child's picture posted on EECSS's website, Facebook page, Youtube channel, and understand that their name will NOT be published.

By clicking YES I consent to receive text messages from EECSS for important updates and notifications. Message and data rates may apply. You can opt-out at any time by replying 'STOP.' We respect your privacy and will not share your number with third parties. *

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EECSS 2025 Registration Form