Surge: Snapshots

Join us for a weekend that will be full of fun and excitement with meaningful messages and worship. This will be a life-changing time for all who go. Other weekend activities include games, black light dodge ball, swimming, basketball and more. July 13-15 we’ll be traveling to Lake Williamson Christian Center in Carlinville, IL for Surge: Snapshots. Time to get a snapshot of who Jesus really is.

We will be meeting at the church at 3:30PM Friday, July13th and anticipate a return to the church around 11:30AM on Sunday the 15th.

Total cost of the trip is $150 due by July 1. Deposit of $75 is due April 22.

To register your child, please submit the form below

Question Title

* 1. Contact Information

Parent/Guardian Name:

Parent/Guardian cellphone:

Parent/Guardian email address:

Question Title

* 2. Emergency Contact Information

Name:

Phone Number:

Secondary Phone Number:

Name:

Phone Number:

Secondary Phone Number:

Question Title

* 3. Child's Name, Birthdate, & Allergies

Child #1 Name:

Birthdate:

Grade:

Allergies:

Child #2 Name:

Birthdate:

Grade:

Allergies:

Child #3 Name:

Birthday:

Grade:

Allergies:

Child #4 Name:

Birthday:

Grade:

Allergies:

Question Title

* 4. Special Conditions: (Please list any special conditions or needs we need to know about)

Question Title

* 5. By clicking this box, you the parent/guardian agree for your child(ren) to attend Surge: Wise Up! at Lake Wiliamson in Carlinville, IL on July 13-15, 2018.

Yes, I agree