Combined Dragon Dates and Teen Scene Virtual BINGO

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Monday July 12, at 5 pm via zoom

Have a fun family game night at home in the company of friends from our Dragon Dates and Teen Scene groups through a virtual BINGO game! We will be playing multiple rounds. Prizes will be given to the first person to get BINGO in each round!

Registration is REQUIRED! Please fill out the following registration form to participate in the Family Resource Network's Virtual Teen Scene and Dragon Dates event. For anymore information please call (607)432-0001.

After registering, an email will be sent to you with the Zoom link for the event as well as the number of BINGO cards needed for participants.

Youth Name or Dragon Dates Member's Name (First & Last) *

First and Last Name of Parent(s) or Guardian(s) *

County of Residence *

Email Address *

Telephone number *

Total Number of Individual's Participating *

TABS# of individual with OPWDD eligibility. If you are unsure of the TABS# please contact your MSC provider. (N/A if not applicable) *

Name of individual's Care Manager (formerly known as MSCs) (N/A if not applicable) *

Does this individual have Self-Directed Services? *

Yes

N/A

Would you like to be added to our email list for information on our future Family Resource Network Events? *

Yes

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