106 Grand Ave NW
Fort Payne, AL 35967-2032
256-845-2015

Forms

2015 Centrikid Release Form

Please click the image below to view and print the release form.  Fill out one copy for each participant.  Each copy must be notarized on the second page.  A notary is available most days Monday-Thursday in the church office from 8:00am-4:30pm.  Also, each completed form must have a copy of the front and back of the medical insurance card for the participant.