Roller Skating Registration
Excelling Church NY is thrilled to host a night of skating, food, and fellowship on Friday November 7th from 8:45 p.m. – 11:30 p.m. at United Skates of America located: 1276 Hicksville Rd, North Massapequa, NY 11783. *A disclaimer that pictures / videos will be taken and by attending you consent to this.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Number of Skating Adults/Children ($35)
1
2
3
4
5
Number of Non-Skating Adults ($15)
1
2
3
4
5
Number of Non-Skating Kids Age 3-17 ($35 - includes game card)
1
2
3
4
5
Payment Options: Please choose how you will pay
Cashapp: $excellingministries (Note: Roller Skating Fundraiser)
Cash
Submit
Should be Empty: