SuperStart

REGISTER NOW, 4th-6th graders! The nation’s largest Gospel-centered pre-teen event is coming to Naperville March 14th- 15th! Throughout the event, preteens will encounter Christ through worship, interactive teaching, and small groups – all of which are designed with their unique needs and maturity in mind.

CCC is looking forward to sponsoring a group of preteens and chaperones to attend the event. Please let us know if you are interested below, and we will be in touch with additional information.

More details on the event are here. Contact Emily Richards with any additional questions.

Adult's Name

First Name

Last Name

Phone

(###)

###

####

Will you be sending your child/children to SuperStart?

Yes

Maybe

Are you interested in being a chaperone?

Yes

Maybe

Name of Child

First Name

Last Name

Child's DOB:

YYYY

Child's Grade and School they attend:

Medical notes (any special needs, allergies, medical conditions we should be aware of):

Name of Child

First Name

Last Name

Child's DOB:

YYYY

Child's Grade and School they attend:

Medical notes (any special needs, allergies, medical conditions we should be aware of):

Name of Child

First Name

Last Name

Child's DOB:

YYYY

Child's Grade and School they attend:

Medical notes (any special needs, allergies, medical conditions we should be aware of):

Name of Child

First Name

Last Name

Child's DOB:

YYYY

Child's Grade and School they attend:

Medical notes (any special needs, allergies, medical conditions we should be aware of):

If you are not the guardian of any of the children, please indicate your relationship to them. We'll follow up to get their guardian's contact information. :

What questions, concerns, or suggestions would you like us to know?:

SuperStart

Chillicothe Christian Church