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Miners Rock! 
It's our Diamonds' Time to Shine! Complete form to paint Miners Rock.
Email *
Miners Rock!  It's our Diamonds' "Time to Shine"! 
First and Last Name - may be used internally in Sign Up Genius, but will not be made public. *
Phone number - for school use only. Number will not be made public. *
Email - may be used internally in Sign Up Genius, but will not be made public. *
Describe general message you plan to paint, for example, "Happy Birthday_______!", "Congratulations to_____", etc.  *
Date you would like your message displayed *
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Back up date if first date is already reserved. 
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Painter's Acknowledgement *
Required
Type any additional questions/concerns here:
A copy of your responses will be emailed to .
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