Breaking BEARriers - Club Recognition Ceremony Registration Form

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The Breaking BEARriers Club is excited to invite you to our first club recognition ceremony. If you have ever attended any of our projects/events, have supported our club in any way, or have displayed any interest toward our club, please feel free to sign up for this event. There will be an appreciation gift for all attendees as well as fun and games for everyone. We hope to see you there!

Date - Sunday November 7, 2021
Time - 1:30-3:30 pm PST
Location - Fallon Middle School MPR (there will be signs directing to this room!)

Email *

Please register for this event in the form below.

First and Last Name *

Are you a current club member? *

Yes

Grade Level (if not in school, type "N/A") *

Middle School

9th grade

10th grade

11th grade

12th grade

College

N/A

School (if not in school, type "N/A") *

Contact Email *

Consent for photo release *

Yes

How many people have you invited to attend? *

1-2

3-4

5-6

A copy of your responses will be emailed to the address you provided.

Submit

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