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Neighborhood Night Out Registration Form

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Eagle Springs Neighborhood/National Night Out Celebration

Saturday ~ October 1st
1:00 p.m. - 4 p.m.
Sports Complex & Soccer Field

Community-Wide Block Parties to Follow!

STREETS REGISTERED by September 1st, will receive an added "Special Incentive" for coordinating their block party and participating in NNO!!

Last year we had some really CREATIVE & FUN parties!

And a PHOTO CONTEST for best photo! Who's going to win this year?

We will once again be having a special "Movie Night on the Green" for the Neighborhood with the most participation! Complete with Popcorn & Drinks!

BUT YOU MUST REGISTER by SEPTEMBER 20th!.........REGISTER TODAY!!

Questions? SAC@SafetyAdvisoryCommittee.com

1. Please use the drop down menu to select the name of your Neighborhood or Village.

	Neighborhood/Village
Please select one:	Please use the drop down menu to select the name of your Neighborhood or Village. Please select one: Neighborhood/Village

Please enter the name of the street(s) you are registering:

2. Please enter your contact information as Coordinator.

Note: The Eagle Springs address you list below is where your packet and incentives will be dropped off at!

Please enter your contact information as Coordinator. Note: The Eagle Springs address you list below is where your packet and incentives will be dropped off at! Name:
Street Address:
Phone:
Email:

3. Unfortunately we are unable to provide t-shirts to those who register after September 1st, as they must be ordered in time for receipt and distribution prior to the event date.

T-shirts are sized as Unisex Adult.

	Please select one below:
My T-shirt size is:	Unfortunately we are unable to provide t-shirts to those who register after September 1st, as they must be ordered in time for receipt and distribution prior to the event date. T-shirts are sized as Unisex Adult. My T-shirt size is: Please select one below:

4. Flyers will be provided for streets that are registered by September 1, 2011. After that date we are only able to provide a template that you may download and print for distribution in your neighborhood.

Would you like flyers to pass out to your neighbors announcing your NNO street/block party?


Please choose from the drop down menu.	Flyers will be provided for streets that are registered by September 1, 2011. After that date we are only able to provide a template that you may download and print for distribution in your neighborhood. Would you like flyers to pass out to your neighbors announcing your NNO street/block party? Please choose from the drop down menu.

Thank You for Registering!

Your Registration will be complete once you hit the SUBMIT button below.

Please note: Information collected is for the sole purpose of coordinating our Eagle Springs Neighborhood Night Out Event. No information is made public.

Neighborhood Night Out Registration Form

1. Please use the drop down menu to select the name of your Neighborhood or Village.

2. Please enter your contact information as Coordinator.Note: The Eagle Springs address you list below is where your packet and incentives will be dropped off at!

3. Unfortunately we are unable to provide t-shirts to those who register after September 1st, as they must be ordered in time for receipt and distribution prior to the event date.T-shirts are sized as Unisex Adult.

4. Flyers will be provided for streets that are registered by September 1, 2011. After that date we are only able to provide a template that you may download and print for distribution in your neighborhood.Would you like flyers to pass out to your neighbors announcing your NNO street/block party?

Thank You for Registering! Your Registration will be complete once you hit the SUBMIT button below. Please note: Information collected is for the sole purpose of coordinating our Eagle Springs Neighborhood Night Out Event. No information is made public.

2. Please enter your contact information as Coordinator.

Note: The Eagle Springs address you list below is where your packet and incentives will be dropped off at!

3. Unfortunately we are unable to provide t-shirts to those who register after September 1st, as they must be ordered in time for receipt and distribution prior to the event date.

T-shirts are sized as Unisex Adult.

4. Flyers will be provided for streets that are registered by September 1, 2011. After that date we are only able to provide a template that you may download and print for distribution in your neighborhood.

Would you like flyers to pass out to your neighbors announcing your NNO street/block party?

Thank You for Registering!

Your Registration will be complete once you hit the SUBMIT button below.

Please note: Information collected is for the sole purpose of coordinating our Eagle Springs Neighborhood Night Out Event. No information is made public.