REGISTRATION

How many children are you registering ?

Child's Information

Name

Age

Grade:

School:

Does this child have any allergies or physical limitations that the staff should be aware of?

#2 Child's Information

Name

Age

Grade:

School:

Does this child have any allergies or physical limitations that the staff should be aware of?

#3 Child's Information

Name

Age

Grade

School

Does this child have any allergies or physical limitations that the staff should be aware of?

Parent/Guardian Information

Name:

Cell Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Work Phone Number

Address

If you cannot be reached, who should be notified IN CASE OF EMERGENCY?

Name

Phone Number

Alternative Phone Number

Additional Individuals Approved to Pick Up

Name

Phone Number

Relationship to Child

Name

Phone Number

Relationship to Child

Annual Registration Fee

2025 Fee ($5 per child) ($5.00)
2025 Fee ($5 per child) ($10.00)
2025 Fee ($5 per child) ($15.00)
Please contact me to pay in cash or by check ($0.00)
If the registration fee presents a financial hardship, please select this option to register at no cost. We believe everyone should have the opportunity to participate. ($0.00)

Terms

By signing below, I acknowledge that The Salvation Army, its officers, staff and/or volunteers will not be held responsible for any injury, loss or damage of personal property for the above named individual(s).

If my child will be absent from the program or will be picked up early, I will contact The Salvation Army at least 24 hours before the event/program. I agree to pick up my child at the specified time until other arrangements have been made. I understand that The Salvation Army will not release my child to any individual not listed as a guardian/parent or approved contact.

I give permission to copyright and/or publish images of my child in photographs and/or any media format for the expressed use of The Salvation Army.

I, the undersigned, agree to the terms above.

REGISTRATION

Child's Information

#2 Child's Information

#3 Child's Information

Parent/Guardian Information

If you cannot be reached, who should be notified IN CASE OF EMERGENCY?

Additional Individuals Approved to Pick Up

Billing Information