Event registration
Event Timing: July 28th-31st, 2019 from 6:30-8:30pm nightly
Event Address: 705 N. High Street, Neosho, MO 64850
Contact us at (417) 451-3169 or email office@northsideneosho.com
Child's Name *
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Child's Gender *
Child's Age *
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Child's Date of Birth *
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Last School Grade Completed *
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Name of parent(s) *
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Street Address, City, State, & Zip *
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Home Phone
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Parent/caregiver's cellphone *
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Email *
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Home Church
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What days can child attend?
Dietary restrictions *
Allergies or other medical conditions *
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In case of emergency, contact *
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Emergency contact phone *
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Emergency contact's relationship to child *
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I understand that a parent/guardian needs to be present promptly at 8:30pm to pick-up their child. *
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