Fall Chat and Chew Registration

FALL CHAT & CHEW!
Join us for K-4 Fellowship on Wednesdays, from 5:30 - 7:00 pm
Sept. 10, Oct. 1, Oct. 15, Oct. 29, Nov. 19, Dec. 3, Dec. 10
Children will make a craft, have music time with Ms. Caitlyn, share dinner, and learn bible stories and games with Ms. Elizabeth. Older youth encouraged to volunteer!

Parent Name

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Email

*

This address will receive a confirmation email

Phone

*

Address

*

Child(ren)

Child Name

Child's Age Group

Please select all that apply.

Pre-K Elementary Middle School Helper

Allergies? Information we should know.

Child Name

Child's Age Group

Please select all that apply.

Pre-K Elementary Middle School Helper

Allergies? Information we should know.

Child Name

Child's Age Group

Please select all that apply.

Pre-K Elementary Middle School Helper

Allergies? Information we should know.

Child Name

Child's Age Group

Please select all that apply.

Pre-K Elementary Middle School Helper

Allergies? Information we should know.

Dates and Payment

Dates Attending

Please select all that apply.

Wednesday, Sept. 10 Wednesday, Oct. 1 Wednesday, Oct. 15 Wednesday, October 29 (Halloween Theme - For Middle Schoolers Too!) Wednesday, Nov. 19 Wednesday, Dec. 3 Wednesday, Dec. 10

Payment ($10 per child; $20 Cap per family, per session)

1 Child; 1 Session ($10.00) 2 Children or more; 1 Session ($20.00) 1 Child; 2 Sessions ($20.00) 2 Children or more; 2 Sessions ($40.00) 1 Child; 3 Sessions ($30.00) 2 Children or more; 3 Sessions ($60.00) 1 Child; 4 Sessions ($40.00) 2 Children or more; 4 Sessions ($80.00) 1 Child; 5 Sessions ($50.00) 2 Children or more; 5 Sessions ($100.00) 1 Child; 6 Sessions ($60.00) 2 Children or more; 6 Sessions ($120.00) 1 Child; 7 Sessions ($70.00) 2 Children or more; 7 Sessions ($140.00)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

FALL CHAT & CHEW!
Join us for K-4 Fellowship on Wednesdays, from 5:30 - 7:00 pm
Sept. 10, Oct. 1, Oct. 15, Oct. 29, Nov. 19, Dec. 3, Dec. 10
Children will make a craft, have music time with Ms. Caitlyn, share dinner, and learn bible stories and games with Ms. Elizabeth. Older youth encouraged to volunteer!

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