Missions Journey: Kids 2024-2025
Wednesday Nights 5:50-7:30 | "Missions Journey: Kids" Students preK-5th grade are invited to join us!
Child's Name
*
Child Grade (Must be at least 3 yo)
*
Please select one option.
pre-K
K
1
2
3
4
5
Date of Birth
*
Gender
*
Please select all that apply.
Female
Male
Parent Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Food Allergies/Health concerns
T-shirt Size
*
Please select one option.
YXS (2-4)
YS (6-8)
YM (10-12)
YL (14-16)
YXL (18-20)
AS
AM
AL
The cost for each student is $30. I would like to:
*
Please select all that apply.
Pay In Person
Pay Online
Payment: $30
I am paying in person ($0)
I am paying online ($30)
I am paying in person ($0)
I am paying online ($30)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Wednesday Nights 5:50-7:30
"Missions Journey: Kids" Students preK-5th grade are invited to join us!
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