OZONE Winter Breakaway 2026
A night for our HS students to reset and begin a new year together.
Friday, January 23rd, 5:30-9:00PM
This event will take place in Springdale at the Samartian Community Center (1520 W Huntsville Ave.) Transportation will be provided from the CWE Rogers Center & Calvary Baptist Church at 5pm and be back by 930PM. Dinner will be provided.
Student Information
Student Name
*
First Name
Last Name
Grade
*
Gender
*
Male
Female
OZONE City
*
North (Bentonville & Rogers)
Springdale
Fayetteville
Parent/Guardian Information
Name
*
First Name
Last Name
Primary Number
*
Secondary Number
*
E-mail
*
example@example.com
Does your child have an allergy which requires an epi pen? If yes, please provide any information reguarding your child's allergy (reaction, treatment, ect.)
*
Does your child have an allergy which DOES NOT require an epi pen? If yes, please provide any information reguarding your child's allergy (reaction, treatment, etc.)
*
Does your child have any special food concerns?
*
BRING YOUR FRIENDS!
Do you want us to invite some of your friends?
Yes
No
If yes, what is their name & phone number and we will send them the sign up link!
Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
*
Submit
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