Summer Celebration 2023

List Child/Children First and Last Name(s), Age(s), Grade(s) completed

Allergies (list each child separately)

Medical Concerns/Comments (list each child separately)

Other Important Medical Information (list each child separately)

Parent/Guardian First and Last Name (required)

Parent/Guardian Email (required)

Parent/Guardian Address (required)

Parent/Guardian phone number (required)

Emergency Contact and relationship (required)

Emergency Contact Telephone number (required)

Child Pick up Authorization- The following individuals are authorized to pick-up my child/children from Stellar- Summer Celebration, June 28-30, 2023. Individual must present valid photo ID. Please list name and relationship to child/children. If it will be you just type self. (Required)

I understand by typing my name and submitting this form I give permission/consent for my child/children to participate in and attend “Summer Celebration- Stellar,” and to use transportation as needed to and from Frontline Worship Center/Frontline Ministries International from June 28-30, 2023. Frontline Worship Center/ Frontline Ministries International has permission to treat my child/children in case of accident or injury. I will not hold Frontline Worship Center/Frontline Ministries International responsible/ liable for said accident or injury. (Required)