JCP&L

Phone: (913) 268-6500

Email:

Mailing Address: 11400 Johnson Drive, Shawnee, KS 66203

JCP&L will not meet during the month of August. See you on September 3.

Wednesdays 6:30 p.m. to 8:00 p.m. Join our Facebook group for details. JCP&L Facebook

JCP&L

Child's Name*

Grade*

Birth Date*

Age*

Gender*

Male

Female

Do you regularly attend church?

If yes, where?

Parent or Legal Guardian*

Address*

Email*

Phone*( ) -

Phone number where you may be reached during JCP&L.

Medical Information or Allergies

Emergency Contact*

Who do we call if you cannot be reached?

Emergency Contact Phone Number*( ) -

Authorized to pick up*

Permission to photograph?*

Yes

Photos may be used for publicity and/or placed on our church website.

Questions, Comments or Concerns

Please leave this field blank.

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