KIDS NIGHT OUT REGISTRATION FORM Thursday, June 13th: 6pm-7:45pm
IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL UPON COMPLETION OF THIS FORM please email the information requested on this form to bgolden@minisink.com or call Coach Golden at (845) 355-5166 THANK YOU
Email address *
(Child's) Last Name *
Your answer
(Child's) First Name *
Your answer
(Child's) Age *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone # *
Your answer
Does your child have any Medical Conditions we should be aware of? (Diabetes, Asthma etc) If so please let us know and be sure to send them with anything they may need. Please include any special instructions you would like us to have. *
Your answer
If you do not receive a confirmation email upon completion of this form (please check spam) you have not been properly registered. Please try again and/or email bgolden@minisink.com with the above information. If Registrations are not received we can not guarantee entrance to the event due to supervision requirements for the safety of all participants. THANK YOU *
Required
I understand that I will have to pay cash and or check ($15) made out to Minisink Valley School District for Entrance to Event *
Required
A copy of your responses will be emailed to the address you provided.
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