GLOW Night Registration
Event Time: April 13 8:30 P.M. - 10:30 P.M.
Event Address: 909 Proprietors Road Worthington, OH. 43085
Contact us at (937) 776-8059 or 777jwong@gmail.com
Parent's Name *
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Parent's email *
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Parent's cell phone *
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Address *
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Child's name *
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2nd child's name (Fill out if more then one person is coming from your family)
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3rd child's name (Fill out if more then one person is coming from your family)
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4th child's name (Fill out if more then one person is coming from your family)
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Dietary restrictions *
I understand that I will have to pay $5 upon arrival. *
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