Club DJ Registration - Countryside Community Church

Your Child has been Registered

Thank you for registering your child. Club DJ runs Wednesdays from 6:30-8:00. to e-transfer your registration fee send them to giving@ccclacrete.com with Club DJ registration in the memo

Club Member’s First Name

Club Member’s Last Name

Mailing Address

City

Postal Code

Phone

Parent’s Name(s)

Allergies

Birth Date (YYYY-MM-DD)

Gender(required)

Boy Girl

School

Grade

Age

Home Church

Previous Club DJ member?

Yes No

I would like to pay my $50/child Registration fee for my child(ren) by:

Cash Cheque made out to Countryside Community Church (Club DJ registration in the memo) e-transfer to giving@ccclacrete.com (memo of Club DJ Registration) I would like to speak to someone about sponsership

Authorization of Parents:

Your Child has been Registered

Contact information