Mother's First and Last Name

Father's First & Last Name

Phone Number

Email Address

Address

Have you been a member of any Eagle's Nest group before? If so, which ones?

Church Home

Please provide information on ALL of your children who would participate (if a spot becomes available) in Voyagers for the upcoming school year.

This includes infants through High School. High School students have an option to participate in Voyagers by assisting in our classes. Please don't forget to include those little ones who will be coming with you. We need to plan a spot for them too. All children who will be coming with you should be listed below so we ensure there is a spot for everyone. Thanks!

Child 1 - Name

Child 1 - Birth Date

Child 1 - Grade for the Upcoming School Year

Child 2 - Name

Child 2 - Birthdate

Child 2 - Grade for the Upcoming School Year

Child 3 - Name

Child 3 - Birthdate

Child 3 - Grade for the Upcoming School Year

Child 4 - Name

Child 4 - Birthdate

Child 4 - Grade for the Upcoming School Year

Child 5 - Name

Child 5 - Birthdate

Child 5 - Grade for the Upcoming School Year

Do any of your children have special needs? If so, please briefly explain.

Please add any additional information you feel would be helpful for us to know.