Disciple Now 2017 Online Registration

Student Information

Gender *
T-Shirt Size *
Grade *

Parent & Emergency Contact Information

If parent is unavailable, please list an emergency contact.
NOTE TO PARENTS:
Each student must have a current medical release form on file with Country Acres Baptist Church.  New forms can be found online at edge-students.com (under events tab). 
 
If your child needs to leave during part of the weekend, please note specific reasons/times/days you are giving them permission to leave.
Parent Signature *
clear
calendar
Powered byFormsite