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Ignite the Light Participant Form
Visit our website for more information at
https://ignite-the-light2.webnode.com/
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@ignitethelightorg
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* Indicates required question
Email address
*
Your answer
Phone number
*
Your answer
Parent's first and last name
*
Your answer
Participant's first and last name
*
Your answer
Allergies? If none list "none"
*
Your answer
If there are allergies, are they airborne?
Your answer
Emergency contact number
*
Your answer
Does your child use a wheelchair or is unable to go up and down stairs?
*
Yes
No
Number of people per family attending
*
Your answer
Can your child be in photos and have photos taken of them?
*
Yes
No
Would you like for your child to have a buddy with him/her throughout the night?
*
Yes
No
Anything you would like us to know about your child?
Your answer
Do you prefer email or text as a way to get into contact with updates and information?
*
Email
Text
For any questions or concerns please feel free to email us at
ignitethelightorg@gmail.com
Thank you!
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