Summer Spectacular 2010
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1. Copy of page: Default Section
1
. How many children are you registering for Surf City's Summer Spectacular 2010?
How many children are you registering for Surf City's Summer Spectacular 2010?
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. What days will your children be attending?
What days will your children be attending?
Friday
Saturday
Sunday
*
3
. Who will be the the EMERGENCY CONTACT for the children you are registering?
Who will be the the EMERGENCY CONTACT for the children you are registering?
Name:
Company:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Country:
Email Address:
Phone Number:
*
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. Please list each child(s) FIRST and LAST NAME you are registering and their SCHOOL GRADE for 2010.
EXAMPLE:
Johnny Smith K
Susie Smith 1st
Joey Smith 5th
Please list each child(s) FIRST and LAST NAME you are registering and their SCHOOL GRADE for 2010. EXAMPLE: Johnny Smith K Susie Smith 1st Joey Smith 5th
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. Fiinally, how did you hear about Surf City's Summer Spectacular event?
Fiinally, how did you hear about Surf City's Summer Spectacular event?
Flier
Movie at the Park
Website
Friend
I am a member of Ocean View Church
Other
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