WOW Registration

If school is cancelled or has an early out we will not hold WOW. Please call to let us know when your child will be absent. Call Marcia Taylor at 319-231-7983 or Becky Lassen at 319-640-7523.

* Indicates required field

1st Child's Name *

First

Last

Grade in school *

Birthday including year *

Allergies or Medical Conditions and instructions *

2nd Child's Name *

First

Last

Grade in school *

Birthday including year *

Allergies or Medical Conditions and Instructions *

3rd Child's Name *

First

Last

Grade in school *

Birthday including year *

Allergies or Medical Conditions and Instructions *

Children arrival (mark those that apply) *

Can walk/bike from school Parent or adult will drop off (come into church to sign child in)

Children departure from church *

Can walk/bike from church Parent or adult will pick up (come into the church to sign out child) A predetermined adult will pick up (fill out name and phone below)

Can pictures or videos be taken of your children and posted on social media sites?

Choose One *

Yes No

Phone Numbers of all adults to pick up child(ren) *

Adults other than parent with permission to pick up child(ren) and phone number *

Mother's Names *

Father's Name *

Parents' Cell Phone numbers *

Parents' Emails *

Parent Street Address *

Parent Mailing Address *

Comment, Anything else we need to know *

Submit