WNL Registration

Wednesday Night Live
Registration Form

Name of Child ______________________________________Grade_________

Date of birth _____________________________________________________

Parents Name ___________________________________________________

Address_________________________________________________________

City_______________________________ State_________Zip____________

Phone # ___________________________ Cell#________________________

E-mail address___________________________________________________

Emergency Contact_______________________________________________

Phone #________________________________________________________

Home Church____________________________________________________

Name of School__________________________________________________

Teacher's Name __________________________________________________

Known Allergies__________________________________________________

Address of Parent or 2nd parent if other than above

________________________________________________________________

Special Needs____________________________________________________

What else would you like us to know about your child?

________________________________________________________________

Do you have any hobbies you might like to share?

________________________________________________________________

Younger siblings names and ages

_________________________________________________________________

Parents!! -Come Join the
Wednesday Night Live Team!!

WNL is a dynamic, fun-filled program loaded with opportunities for adults and older youth to establish meaningful relationships with children. You don't need to have special skills.

Parents if your child is signed up for WNL we need your help in
at least one of the areas below. If you are new to the program or
don't know anyone, sign up for the Kitchen Crew, it's easy work
and a kitchen always makes people feel at home.

The lower portion of this form lists some of the ways you can help. Please mark items you are interested in and return the form to the church. If you need more information, please call me at the church (734-5129) or at home (734-6447) or e-mail at memys85@hotmail.com.

The success of this program largely depends on the participation of
many parents and volunteers.

Thank you in advance for your help and support of our children.

Margie Myers, Director, WNL
_________________________________________________

(Check all that apply)
_____Discussion guide/leader (weekly)
_____Snack provider (occasional) Also sign dated sheet on
            office door.
_____Skit Leader (weekly)
_____Craft coordinator (rotating basis)
_____Craft helpers (rotating basis)
_____Games coordinator (rotating basis)
_____Game helpers (rotating basis)
_____Table Parents (weekly). We will need 14-16 people.
_____Driver (weekly at an assigned school; 15-30 minutes)
_____Kitchen Crew (rotating basis)

Name____________________________________________

Phone____________________________________________