2019 Eat, Connect + Learn: WAIT LIST

THIS IS THE WAIT LIST FOR EAT, CONNECT + LEARN. REGISTRATION MUST BE COMPLETED BY THE ADULT OR PARENT/ GUARDIAN OF THE CHILD WHO WOULD JOIN THE WORKSHOP IF A SPOT BECOMES FREE. WE WILL CONTACT YOU WHEN SPACE BECOMES AVAILABLE IN YOUR DESIRED WORKSHOP. ONCE YOU SUBMIT THIS REGISTRATION, WE ENCOURAGE YOU TO SIGN UP FOR YOUR SECOND CHOICE TO ENSURE A SPOT AT EAT, CONNECT + LEARN.




Name of Attendee
Type first name as it should appear on name tags
Last Name
Date of Birth (dd,mm,yy)
Contact Information
Parent/Guardian First Name (If Attendee is a child)
Parent/Guardian Last Name (If attendee is a child)
Address
City
Province
Postal Code
Email Address (This is our first form of communication with you)
Phone Number
Sign Up Details
Notify me if a spot becomes available in the following workshop:
Please sign the attendee up for:
If an alternative meal is required for medical or religious reasons, please choose:
Please provide details regarding any health issues that will help us care for you:
Transportation is available to the Kingscourt Drive area and Victoria Hills neighbourhood. May we offer you a ride to Eat, Connect + Learn?
Is this your first time at WMB Church?
How did you hear about Eat, Connect + Learn?
If other please provide details:
Consents
Picture Consent: Understanding that WMB does not include names with their pictures in any promotional material, I consent to the use of pictures/videos taken of me/my child at activities and events, for website, promotional and reporting purposes.
Medical Consent: I consent to let program leaders seek medical attention for me/my child if immediate attention is deemed by the program leaders to be required.
Data Consent: I consent that the information provided through this registration may be added to the WMB church database to be used for church program purposes only, and not to be distributed to any outside party.
I understand submission of this registration implies an electronic signature


Are Required Fields