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Clarks Summit United Methodist Church

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Check out our new B.L.A.S.T!

Thursday evenings beginning September 15, 2022

Address *

Ages/Grade

Pre School

Kindergarten

Grade1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Adult

Parent/Guardian Name: *

Allergies/Medical Issues to be aware of

Comments/Questions:

Child's Name *

Child's Name

Ages/Grade

Pre School

Kindergarten

Grade1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Adult

Allergies/Medical Issues to be aware of

Child's Name

Please fill out the registration form below to register for B.L.A.S.T. for the 2022-2023 year!

Allergies/Medical Issues to be aware of

Ages/Grade *

Pre School

Kindergarten

Grade1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Adult

Thank you for contacting us! If needed, you will hear back within 48-72 hours.

B.L.A.S.T. Registration Form 2022-2023

Email: *

Check here to receive email updates

Emergency Phone *

Date and time *

Phone *

1310 Morgan Hwy

Clarks Summit, PA

18411

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