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Senior High Pilgrim Fellowship Registration 2009-2010CLICK HERE FOR A PRINTABLE "pdf" FORM
New ________ Returning ________
Name __________________________________________________________________
Age__________ Date of Birth _____________ Grade __________________
Name___________________________________________________________________
Age___________ Date of Birth ______________ Grade __________________
Parents’Names___________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
Address(es)_____________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
Home Phone_____________________ Cell phone _________________________
Email__________________________________________________________________
Contact Preference : email phone
Photo Release: Granted Denied
Do you have any special needs or allergies we should be aware of ? _____________________________________________________________
Would you be willing to volunteer from time to time or help with special programs? Yes No
Check which volunteer opportunities might interest you:
________ Help out in nursery one Sunday a month ________ Help out in the Sunday School Program ________ Help with potluck suppers and picnics ________ Help with special crafts ________ Help with the Christmas Pageant and other special programs ________ Help with Food Pantry
Any special skills you’d like to share? _________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
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1st Congregational Church of
Old Lyme
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