Power Up Parent Permission and Application Form
Please complete the entire form to be eligible for a Power Up Weekend Pack
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Email *
Parent Name *
Parent Phone Number *
Street Address *
City *
Zip Code *
Please List the Children in your Family Who Attend:  West Middle School (First and Last Names) *
Do you have access to a microwave
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Do any of your children have food allergies; if so please list them along with the child's name.
By Submitting this form you are applying for the Power Up Weekend Pack.  By submitting this form you release and hold harmless Radiant Church and it's food donors of any and all liability. *
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