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Event registration
Event Date: Sunday, August 29, 2021
Time: 2pm-6pm
Event Address: Savoy Recreation 402 W. Graham St. Savoy, IL
Contact us at stoptheviolence409@gmail.com
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GOD IS RAW: STOP THE VIOLENCE
Community Back to School Intervention

Name:(First/Last) *
D.O.B *
GENDER: *
GRADE LEVEL: *
PARENT/GUARDIAN NAME:(IF UNDER 18 ONLY) *
ADDRESS: *
PHONE NUMBER: *
Email *
HEALTH PROBLEMS: *
What are your goals? *
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