The Amazing Race An Adventure to Success - Family Relay at Pickett Academy
RequiredRequired Question(s)
Registration is required, please complete the form below to register your family.
We'll see you on May 10, 2017, at 4:30 PM!
 
Required 1.
How did you hear about the event
Flyer my child brought home
Via email message
Via the pricipal
From Sierra, Dan or Ms. Faith (The program facilitators)
From a teacher at Pickett Academy
Other  
Required 2.
Please enter the information indicated below:

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:
School:
Student Name:

Required 3.
How many people will be attending (include yourself)? 
We will be serving a family dinner and would like to know how many family members will be in attendance. Please enter the total number and complete name of each attendee.
 

50 characters left.
Required 4.
Is there anyone in the family with food allergies? Please list below.
 

50 characters left.