Your name

Your email

Your Phone:

Subject

Select all that apply (required)
Talk with a PastorConnect with a small group or missionOpportunities for childrenMore info about Creekwood UMC in general

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Your name

Your email

Your Phone:

Subject
Pastors Only

What is your Prayer Request?
(Provide as much detail as you are comfortable sharing. One of the Pastors will contact you.)

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Your name

Your email

Subject

Your message
(Please keep comments to 250 words)

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Your name

Your email

Your Phone:

Subject

Which Worship service are you available for?
8:30 Traditional11:00 ContemporaryEither Service

How would you like to serve?
Serve CommunionRead ScriptureUsherGreet GuestsHospitalityAV/Media Support

Additional Information

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Your name

Your email

Your Phone:

Subject

Date of Salvation

Brief Testimony (250 words max.)

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Subject:

Name of Parent/Guardian: (serves as digital signature)

Address:

Best Parent Contact Phone Number:

Parent email:

I give permission for photographs in which I and my child(ren) or just my child(ren) appear to be used for publications, newsletters, and public relations activities by Creekwood United Methodist Church.
YesNo

Children's Full Name: (One-Name Per Line Please)

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Subject:

Name of Parent/Guardian: (serves as digital signature)

Parent Email:

Best Parent Contact Phone Number:

Children's Full Name: (One-Name Per Form Please)

Allergies:

Medical Conditions:

Medications: (One medication and dosage per line)

To the best of my knowledge, my child is physically able to participate in summer camp.
YesNo

Dates Permission Granted:

Authorization for Emergency Medical Care.
In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to the nearest appropriate emergency medical care facility. Furthermore, I give consent for the facility to secure any and all necessary emergency medical care for my child.
YesNo

Please provide doctor's name and phone number.

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