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Barnes & Noble (Luzerne County)
- Family Sign-up Form
Use this form to sign up to attend our event at Barnes & Noble
in Luzerne County
on Friday, April 26th, 2024. More information about this event can be found
here
. Specific event details will be sent via email one week prior to the event.
This form will remain open until 4:00pm on Thursday, April 18th.
Please note that this form must be filled out by a parent or legal guardian.
*
If you have questions about this event, please contact
Kristin Seidel (
krseidel@insightpa.org
or 570-807-1779)
.
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* Indicates required question
Parent/Guardian FIRST NAME
*
Your answer
Parent/Guardian LAST NAME
*
Your answer
Parent/Guardian EMAIL ADDRESS
*
All event communications will be sent to this email address. Please confirm that your email has been entered accurately.
Your answer
Parent/Guardian PHONE NUMBER
*
Your answer
How many Insight PA students will be attending this event?
*
If you need to register more than five students, please contact Kristin Seidel (
krseidel@insightpa.org
).
Choose
1
2
3
4
5
How many additional children (non-Insight PA students) will be attending this event?
*
Include the number of additional children who will be attending here. You to NOT need to include them when you list the students who are attending in the next section of this form.
Your answer
How many adults total will be attending this event?
*
Your answer
How many total people (including all children and adults) will be attending this event?
*
This number will be used when calculating totals for our lunch order. Please make sure this number is accurate!
Your answer
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