Clone of Fun Night: Whirley Ball January 25th 2025

Fun Night- Whirley Ball: 5055 Richmond Rd, Bedford Heights, OH 44146

Sunday, April 19th, 2025 6:00-8:00
Name*

First NameLast Name
E-mail*
example@example.com
E-mail good to contact for future events
example@example.com
Emergency Phone Number*
Facebook/InstagramAttending MassChurch BulletinEmailOther
Will you be carpooling with other children?*
Whirley Ball has their own waiver that must be signed. Please copy and paste the link on the web browser and fill it out on the website here: https://whirlyballcleveland.com/waiver-form
YesNo
Photo Release: I, the parent/guardian of my minor child do hereby consent and authorize the release, publication, dissemination, distribution, use, and/or reproduction of any and all photographs and/or filming taken of my daughter/son during his or her enrollment of parish youth group events at Church of the Assumption parish by an employee, agent, or representative. This Release and Authorization acknowledges that all videos and photos could be used and publicized on the Youth Group social media pages on Facebook and Instagram as well as the church website. Do you give consent to use your child's photo/image in these ways?*

I acceptI do not accept
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Fun Night- Whirley Ball: 5055 Richmond Rd, Bedford Heights, OH 44146