Friendship Circle of VA: Chanukah on Ice Registration
Sunday, Dec. 22 from 4-6 pm
Skate Nation: 4350 Pouncey Tract Rd, Glen Allen, VA 23060

Ice Skating and sensory room included.
Email address *
Please list all who are attending including parents. (First and Last Name)
Individual with Disability
Sibling
Teen Friend
Parent
Attendee1
Attendee2
Attendee3
Attendee4
Attendee5
Attendee6
Age of Individual with a disability
Your answer
Address, City, ST, Zip
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Is this your first event with Friendship Circle of VA?
How did you hear about us?
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Please list any medical conditions or diagnosis we should be aware of at this event.
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A copy of your responses will be emailed to the address you provided.
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