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Rachel Kurtz Youth Connection Event
For youth in
GRADES 6-12
Event Address: 2800 N. Church Road, Liberty, MO 64068
Contact us at
(816) 781-7991
or chrismmarple@gmail.com
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Please list first and last names and ages of all participants joining from your family
(Grades 6-12):
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Phone Number
AND NAME
of Parent/Guardian:
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Your answer
Phone Number
AND NAME
of Emergency Contact:
*
Your answer
Will your children be staying for dinner and games (pizza, soda, water, and assorted snacks)? 5:30-6:45pm
Yes
No
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Will a parent be joining us for dinner?
1 guardian
2 guardians
3 guardians
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What allergies or medical conditions do we need to be aware of?
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How did you hear about this event?
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Website
Friend
Newsletter
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What Comments and/or Questions Do You Have?
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