Parent/Guardian Name:

HoH/Deaf
Hearing

Email Address:

Telephone #:

Parent/Guardian #2 Name:

HoH/Deaf
Hearing

Child/Teen Name:

Age:

HoH/Deaf
Hearing

Child/Teen Name:

Age:

HoH/Deaf
Hearing

Child/Teen Name:

Age:

HoH/Deaf
Hearing

Child/Teen Name:

Age:

HoH/Deaf
Hearing

Child/Teen Name:

Age:

HoH/Deaf
Hearing

Please check group(s) you are a member of:

FNDC
BC Hands & Voices
CHHA BC Parents Branch
We are not members.
Please contact me about membership options.

How did you hear about this event?

Photos will be taken at this event. May we use photos of your family for our newletters/websites/marketing?

Sure!
No, thanks for asking

Thanks for registering. The cost for this event is $3.00 per person, and will be collected at the door. Cash only, please!