Westover Childcare Registration | Westover Hills Church of Christ

Event Name: *

Parent's First Name: *

Parent's Last Name : *

Parent's Email Address: *

Parent's Mobile #: * (xxx-xxx-xxxx)

1st Child's Full Name:

1st Child's Birthdate: *

2nd Child's Full Name:

2nd Child's Birthdate:

3rd Child's Full Name:

3rd Child's Birthdate:

4th Child's Full Name:

4th Child's Birthdate:

Please list your child's allergies, if any:

Release of Liability : *

Yes

No

By selecting "YES" above, you hereby release all claims and forever hold harmless the staff, employees, and agents of Westover Hills Church of Christ, Austin, TX.

By selecting "YES" above, you attest in good faith that the above information is true and accurate.
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Press the "SUBMIT" button below to complete your "Childcare Registration".