Winter Wonderland - Dance for Exceptional Kids
Friday, January 18, 2018, 7:00-8:30pm Register Participants 10 years of age and older
Participant's Name *
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Participant's Age as of the event *
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Parent/ Guardian Name *
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Parent/Guardian Email Address *
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Parent/Guardian Phone Number *
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Emergency Contact Name, Relationship *
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Emergency Contact Phone Number *
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Does the Participant have any food allergies or restrictions? If yes, please explain.
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Does the Participant have sensory difficulties? If yes, please explain.
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Permission is given by my electronic signature allowing Johns Creek United Methodist Church to post photos of my child/youth/family in media-based presentations and events that highlight various activities and events occurring during the course of the year. *
Electronic Signature *
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I would like to hear more about the opportunities at Johns Creek United Methodist Church for Exceptional Kids. *
What other events besides dances could we offer in which you would be interested?
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