Middle School How many kids are you registering ?Please enter a number from 0 to 2.How many servants are you registering ?Please enter a number from 0 to 2.Parent / Emergency InformationParent/Emergency contact Name First Last Parent/Emergency contact Email(Required) Parent/Emergency contact PhoneFirst Child InformationFirst Child's Name(Required) First Last First Child Birth Date(Required) MM slash DD slash YYYY First Child Grade(Required)Choose one678T-shirt Size(Required)Choose a sizeAdult X-SmallAdult SmallAdult MediumAdult LargeAdult X-LargeFirst Child's Food Allergies Second Child InformationSecond Child's Name(Required) First Last Second Child Birth Date(Required) MM slash DD slash YYYY Second Child Grade(Required)Choose one678T-shirt Size(Required)Choose a sizeAdult X-SmallAdult SmallAdult MediumAdult LargeAdult X-LargeSecond Child Food Allergies First Servant InformationFirst Servant's Name(Required) First Last First Servant's Email(Required) First Servant's Phone(Required)T-shirt Size(Required)Choose a sizeAdult X-SmallAdult SmallAdult MediumAdult LargeAdult X-LargeSecond Servant InformationSecond Servant's Name(Required) First Last Second Servant's Email(Required) Second Servant's Phone(Required)T-shirt Size (Adult)(Required)Choose a sizeAdult X-SmallAdult SmallAdult MediumAdult LargeAdult X-LargePayment OptionPlease choose an option(Required) Pay in Full Pay using 2 monthly payments Total Amount DueTotal Registration Due Amount: $0.00 Donate to support the Ministry Total Due Consent(Required) I agree to the consent belowI give permission for my child, . to take part in the church trip described above. I hereby authorize the trip leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them or the Church responsible for any accident or injury. I understand all reasonable safety precautions will be taken at all times by trip leaders during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold the Church or leaders liable for damages, losses, diseases, or injuries incurred by the subject of this form. Credit Card InformationCredit Card(Required) Cardholder Name Card Details