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Kickball with the Kappas

Lessons for Life Back to School Supply Drive
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Welcome to Lessons for Life "Kickball with the Kappas" Back to School Supply Drive Event!

This event will be on Friday, August 4 6:00pm at the back of Dorey Park.

We are excited to host this event in the community and look forward to seeing all of you out there!

Kickball with the Kappas Event Information:
- The registration fee is $10 per participant.
- Sign-ins will take place at 5:30pm.
- Kickball will start at 6:00pm.
If you have any questions or concerns, please email us at lessonsforlife.vp@gmail.com.

Follow us on social media (IG & FB) @lessonsforlife.rva and visit our website at http://www.lessonsforlife.info

Please complete the registration in full.
Number of Participants*

Participant 1
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Preferred Contact Phone Number*

Area CodePhone Number
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number

Participant 2
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Preferred Contact Phone Number*

Area CodePhone Number
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number

Participant 3
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Preferred Contact Phone Number*

Area CodePhone Number
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number

Participant 4
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Preferred Contact Phone Number*

Area CodePhone Number
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number

Participant 5
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Preferred Contact Phone Number*

Area CodePhone Number
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number

Total*
Registration Fee*

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