Happy Hearts Hoedown Kids Program | Westburne Alliance Church

Child must be accompanied by a parent who is attending the event upstairs to be signed in and out of the Kids Program.

Grandparents, other family members, or friends will not be permitted to sign child(ren) in or out.

List only the name(s) of the parent(s) who will be attending the event upstairs.

Please fill out a separate form for each child who will be attending.

Parent's Name(s) (Required)

Parents must sign their child(ren) in and out of the kid's program.

Parent's phone number (Required)

Please list a number we can call on the night of the event in case of an emergency

Child's Name (Required)

Child's Age (Required)

Does your child have any food allergies? (Required)

If you answered YES, please list them

Does your child have any medical or behavioural needs that we should know about? (Required)

If you answered YES, please explain

Does your child require medication? (Required)

If you answered YES, please list

Solve 1 + 9 = ?

Our Mission

Making disciples who love Jesus and love people.

Our Vision

Connecting to Jesus. Growing Together. Serving our Community.

Westburne Alliance Church

237 Rykert St

St Catharines, ON L2S 3T8

(905) 682-3511

Links