2019 Canvas Junior - Child Registration
University Carillon • June 17-19 (3 days only) • 9-11:30am

COST: $20 per family.

STEP 1: Please complete one registration form per child.

*Please use Firefox, Chrome or Safari.  If you have any technical questions, please contact web@ucumc.net.

CHILD INFO


PARENT/GUARDIAN INFO
**used for communication and confirmation emails - check for typos**


ADDRESS


CHILD MEDICAL INFO


*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for University Carillon use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

  • I have read and understand the above information. The information I have given University Carillon is accurate and true to the best of my knowledge.
  • My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.
  • I understand, no refunds are available for this event.

 

Due upon registration.


When this form is processed, you will receive a confirmation email with payment instructions. Thank you!