Spring Fun

First Name *

Last Name *

Phone Number *

Home Address *

City *

State *

ZIP Code *

Does your child attend School #6 SFLS? *

Yes

No

How many CHILDREN will be attending this event with you? *

I (PRINT NAME OF PARENT),_______________________, grant permission to New Destiny Family Success Centers, Inc. and its staff members the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me, my children and any other members of my family, for the purpose of publication and/or promotion. *