TC Halloween at Scandia
Saturday, October 20, 2018
6:00pm - 12:30am

Meeting at the CCF Office
11155 Mt View Ave, Suite 105
Loma Linda, CA 92354
*CCF provides transportation, dinner, and admission.

PLEASE REGISTER BY FRIDAY, OCTOBER 12, 2018 TO RESERVE YOUR SPOT.

Sign-ups taken on a first-come basis. LIMITED SPACE AVAILABLE.


**If teen registers and does not attend the event, PARENT IS RESPONSIBLE FOR COST OF ADMISSION.

Teen Patient's First Name *
Your answer
Teen Patient's Last Name *
Your answer
Contact Phone *
Your answer
May We Send You Text Notifications?
Contact Email Address *
Your answer
I understand that I must turn in a permission slip to attend this event. *
I understand that I must be at the CCFSC office by 5:45pm on October 20th to DROP OFF. *
I understand that I must be at the CCFSC office by 12:30am on October 20th to PICK UP. *
I understand that I (Parent) will be RESPONSIBLE FOR THE COST OF ADMISSION if my teen DOES NOT attend the trip. *
PARENT'S FULL NAME (This serves as an electronic signature)
Your answer
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