Name *

First Name

Last Name

Are you at least 14 years of age? *

(Minimum age to participate)

Yes

No

Gender *

Male

Female

Special Communication Needs *

Yes

No

Sensory Issues/Concerns *

Yes

No

Allergies *

Yes

No

Food Needs *

Please select all that apply. Select "Other" for additional food needs. If you have no food needs, please select "None".

None

Dairy Free

Gluten Free

Sugar Free

Vegan

Vegetarian

Mechanical Soft

Other

Will guest need medication administered during the event? *

Please note Calvary Chapel Eastside staff and volunteers are not permitted to administer medication to guests during the Summer Sizzle event. If medication is required during the event, the guest, parent, or caretaker MUST administer the medication.

Yes

No

Parent/Caretaker Name *

First Name

Last Name

Parent/Caretaker Phone *

(###)

###

####

Parent/Caretaker Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Parent/Caretaker Name

First Name

Last Name

Additional Parent/Caretaker Phone

(###)

###

####

Emergency Contact Person on June 13, 2025 *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Please read the Media & Liability Rights Release *

Yes, I HAVE READ and AGREE to the CCE Summer Sizzle Media & Liability Rights Release.