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Discover Burnt Hickory Luncheon

Please register each family member that will be attending. Note, children birth through 5th grade will be brought over by a staff member immediately following the Discovery Burnt Hickory class to eat with their families. Please make prior arrangements for your middle school and/or high school students to meet you at the Connection Room for lunch at noon.

*Head of Household #1 - First and Last Name:
Head of Household #2 - First and Last Name:
Primary phone number:
*Primary Email Address:
:
Please register each attending child (where applicable)
Child #1 - Name:
Child #1 - Date Of Birth:
Child #2 - Name:
Child #2 - Date Of Birth:
Child #3 - Name:
Child #3 - Date Of Birth:
Child #4 - Name:
Child #4 - Date Of Birth:
Child #5 - Name:
Child #5 - Date Of Birth:
Emergency cell # for childcare :
:
*TOTAL NUMBER of ALL Family Members Eating Lunch:
If applicable, please select one area you may be interested in learning more about.: