ArtVenture!

Number of children being registered REQUIRED Please fill out this field.
child 1
- Last name REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender Female Male
- Special needs or allergies REQUIRED Please fill out this field.
child 2
- Last name REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender Female Male
- Special needs or allergies REQUIRED Please fill out this field.
child 3
- Last name REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender Female Male
- Special needs or allergies REQUIRED Please fill out this field.
child 4
- Last name REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender Female Male
- Special needs or allergies REQUIRED Please fill out this field.
child 5
- Last name REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Gender Female Male
- Special needs or allergies REQUIRED Please fill out this field.

Parent/Guardian full name REQUIRED Please fill out this field. Please enter valid data.

Best Email REQUIRED Please fill out this field. Please enter an email address.

Best Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Address (if not a parish member) Please enter valid data.

Emergency contact person REQUIRED Please fill out this field. Please enter valid data.

Emergency contact phone REQUIRED Please fill out this field. Please enter valid data.

Disclaimer
1. In the event of a medical emergency, I give St. Mary’s staff the right to authorize treatment deemed necessary to save the life or limb by a licensed physician. All attempts will be made to contact the parent or guardian at the phone numbers provided.

2. I hold St. Mary’s Church, its employees and volunteers, free from any liability resulting from accidental injury or death of the above minor(s).

I have read and agree with the above statement. (Please state your name) REQUIRED Please fill out this field. Please enter valid data.

I can volunteer to help with: Planning Decorations and set-up Art Snacks Bible Story Leader (must be 18 or older) Table leader (7th grade and up) Final clean-up

St. Mary's Parish

Bismarck, North Dakota 58501

ArtVenture!

Earthkeepers ArtVenture has been cancelled

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