Noogie Nights 
Please fill out the form below with your contact information and a member of our staff will be in touch shortly with live class information. If you have multiple children participating, please complete this quick form again for each additional child. Thank you!
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Child's first name *
Child's last name *
Child's age
Parent/Guardian Name(s) and Phone Number *
Parent/Guardian Email Address(es) *
What is your child's connection to cancer? *
Virtual Programs Confidentiality and Safety
https://www.cancersupportannarbor.org/virtualpolicy/
I agree to CSC's confidentiality and safety policy. *
Required
Have you attended a CSC program before? *
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