Middle School Dodgeball Night

All Middle School Students and their friends are invited to join us for an evening of blacklight dodge ball and other active games. Wear neon if you want to glow in the dark, or dress in black to play in stealth mode. Snacks provided. Drop off and pick-up at door 1 in the parking lot off Ramsey St.

DATE & TIME:
Friday, September 18th: 7:00 pm - 8:30 pm

Hope Covenant Church
(336 4th Ave. S, St. Cloud)

Contact olivia@hopecovenant.org with any questions.

Parent/Guardian Information

Parent/Guardian Name

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Phone

Address

Student #1

Student #1 Name

Student #1 Grade

Please select one option.

6th 7th 8th

Student #1 Allergies/Medical Conditions/Special Needs

Student #2

Student #2 Name

Student #2 Grade

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6th 7th 8th

Student #2 Allergies/Medical Conditions/Special Needs

Student #3

Student #3 Name

Student #3 Grade

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6th 7th 8th

Student #3 Allergies/Medical Conditions/Special Needs:

Student #4

Student #4 Name

Student #4 Grade

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6th 7th 8th

Student #4 Allergies/Medical Conditions/Special Needs

Emergency Contact & Photo Release

Who should we contact in the event of an emergency? (Name)

Emergency contact phone number.

I understand and authorize that my child’s image may be photographed or filmed and used in Hope Covenant Church video presentations, printed publications, Web site and on social media.

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Parent/Guardian Signature (type name):

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Middle School Dodgeball Night

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