HANG! registration form - COVENANT CHURCH OF POMEROY

Hang!

Questions? Contact Jen Pearson (712)-359-7706 for additional information.

Registration Form

* Indicates required field

Name *

First

Last

Age *

Grade *

Parents / Guardian *

Address, City, State/Zip *

Home / Cell Phone *

Email *

Emergency Contact *

Emergency Contact Phone *

Allergies | Medical Concerns *

List name(s) of guardian for pick up after Hang! *

Submit