Fort Scott Cinema Movie Event Registration

Adult Names in attendance (First and Last Name)

*

Family info:

*

Foster Adoptive Kinship Guardianship Other

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Name of Agency (if applicable)

Please provide the following information for all children that will be attending. Please include your children's FIRST and LAST name. All information is required to register your family.

Child's full name

Grade

Child's full name

Grade

Child's full name

Grade

Child's full name

Grade

Child's full name

Grade

Child's full name

Grade

Child's full name

Grade

Thank you! We look forward to seeing you there!

Description

Saturday, September 14th and Sunday, September 15th-During open cinema hours

Please fill out this form and click submit.