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The Hub Kidz

The Hub Kidz Movie Night Edition

Please fill out the form below to register for The Hub Kidz Movie Night

Childs First Name*

Childs Last Name*

Child Age*

Picture Upload *Upload A Picture Of Your Child For Ornament Activity*

Emergency Name & Contact*

I agree to release and hold harmless the church and its staff from all liability related to injury or illness that may occur to my child in relation to this event or any activity associated with it.

I agree to drop off my child(dren) by 5:00pm and pick him/her up by 8:10pm.

Parent / Guardian Printed Name*

Signature*

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