Light In The Night Registration

Please complete this form and click the "Submit" button.

Before closing the window, be sure you have received the confirmation message.

Thank You!

Preregistration enters your family for the age appropriate (3 years through adults) door prize drawings.

After clicking on the submit button, wait for the confirmation message that your family has been registered before closing the window.

If you have any questions about your registration, contact Ginger Wallace at gwallace@nlcfamily.org.

Thank you!

Parent Name(s)

This address will receive a confirmation email

Phone

Address

Child #1 Name

Child #1 Age Group

Please select one option.

Pre-school (3 thru 5 years) K thru 2nd grade 3rd thru 6th grades Youth (7th thru 12th grades)

Child #2 Name

Child #2 Age Group

Please select one option.

Pre-school (3 thru 5 years) K thru 2nd grade 3rd thru 6th grades Youth (7th thru 12 grades)

Child #3 Name

Child #3 Age Group

Please select one option.

Pre-school (3 thru 5 years) K thru 2nd grade 3rd thru 6th grades Youth (7th thru 12th grades))

Child #4 Name

Child #4 Age Group

Please select one option.

Pre-school (3 thru 5 years) K thru 2nd grade 3rd thru 6th grades Youth (7th thru 12th grades)

Child #5 Name

Child #5 Age Group

Please select one option.

Pre-school (3 thru 5 years) K thru 2nd grade 3rd thru 6th grades Youth (7th thru 12th grades)

Child #6 Name

Child #6 Age Group

Please select one option.

Pre-school (3 thru 5 years) K thru 2nd grade 3rd thru 6th grades Youth (7th thru 12th grades)

Description

Please complete this form and click the "Submit" button.

Before closing the window, be sure you have received the confirmation message.

Thank You!

Light In The Night Registration

Description

Please Fix the Following