Event registration
Event Timing: June 10, 2024-June 14, 2023  6pm-9pm
Event Address: 6402 Peters Creek Rd, Roanoke VA 24019
Contact us at shannon@nrbc.org
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Child's Name *
Child's Date of Birth *
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Grade Completed as of July 1, 2024
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Any Food Allergies? *
Parent Name *
Parent email *
Parent Address
Parent Phone Number *
Best Method of Contact (check all that apply)
Do you give permission for your child to be videographed/photographed during the event for promotional purposes?
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Who has permission to pick up your child?
Church most often attended?
Is there anything else we should know about your child?
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