Roseville Church - Test Adv. Form

Parent/Guardian Contact

First Name

Last Name

Gender

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Email

Phone Number

Child

First Name

Last Name

Gender

Grade

Email

Allergies

Are there any behavioural concerns?

Attendance

My Child(ren) will attend the following dates

Day One

Day Two

Day Three

Day Four

Photo Consent

Yes, I consent to photos of my child being taken and used in relation to Adventure Week on the Roseville Church website, social media, and other media channels.