Lil' KidQuest Registration

Online registration for this event will close at 11:59pm on Saturday, June 2nd. New registrations will continue to be taken on Wednesday morning at the event. We recommend new registrations arrive by 9:30am to avoid long lines.

Click here to download a registration form (just one page). You can mail it in along with your check for $30 made payable to Discovery Christian Church, 988 Rt. 228, Mars, PA 16046

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KidQuest

Lil' KidQuest Registration
KidQuest Registration

Discovery Christian Church • 988 Rt. 228 • Mars, PA 16046 • (724) 779-1010

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First Name
Last Name
Email Address
Phone Number	(Format: 999-999-9999)

Mobile Number
Father's Name
Mother's Name
Child Lives with	Both Parents Father Mother Other Guardian
Street Address
Apt/Suite Number
City
State
Zip Code
Birthdate
Age
Gender	Male Female
Grade in fall 2012	Preschool Kindergarten n/a
Please list any food allergies
Medical Information?
Insurance Provider
Insurance Policy #
Do you regularly attend church?	Yes No
Where do you regularly attend church?
Shirt Size	Youth XS (3T/4T) Youth Small Youth Medium
Who may pick up your child? Please list all possibilities. Please also include phone numbers.
I have read and agree to the "Terms and Conditions" stated below.

First Name
Last Name
Email
Phone
Address

City
State/Province
Country
Postal Code

Credit Card Type
Credit Card No.
CCV
Expiration Date	/
	or Cancel

Lil' KidQuest Registration

Registration Payment

Billing Information

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KidQuest