Child's Full Name *


Grade: *


Age on first day of event: *


Parent/Guardian Name(s): *


Phone: *


Address: *


City: *


Postal Code: *


Your Email: *


Emergency Contact (Name): *


Emergency Contact (Phone): *


Food Allergies? *


Church Home (if any): *


Do you grant us permission to publish your child's photo on our website or other publications? *
yes no

If Resurrection participates in the Big Valley Parade, would your child be interested in riding on our float (July 28)? *
yes no

Questions for us?