Stellar 2024

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June 9th- 13th
6:00-8:30 pm

Registering Child Information

Student Name

*

Gender

*

Please select one option.

Male Female

Birth Date

*

Please register your child according to the following choices. If you have any questions, please leave a note! Thank you!

Age Group

*

Please select one option.

Age 4 (by June 9th) Age 5, but not yet starting Kindergarten this fall Starting Kindergarten this fall Finishing Kindergarten Spring 2024 Finishing 1st Grade Spring 2024 Finishing 2nd Grade Spring 2024 Finishing 3rd Grade Spring 2024 Finishing 4th Grade Spring 2024

Note/Questions:

Family Information

Parent Name

*

Relationship to Child

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Other Information

Does my child have food allergies or medical concerns?

*

Please select one option.

Yes No

If yes, please explain.

By registering your child, you are consenting to your children being photographed and on video for Heartland's social media and promotional channels.

If you would like more information about opting out, please email our Communications Coordinator Rachael at rbomsta@heartlandfree.com

How did you hear about our VBS? (check all that apply)

*

Please select all that apply.

We attend church at Heartland! We visited church at Heartland and heard about it. We were invited by a friend/family member. We saw the parade float. We saw the posters in town. We saw the banner in front of the church. Facebook post Other

Description

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