Sedgwick County, Kansas...working for you

Sedgwick County...working for you
Sedgwick County, Kansas

525 N. Main  ●   Wichita, KS 67203  ●   Tel: (316) 660-9000
www.sedgwickcounty.org

Shocks, Cops and Kids

When:  Saturday, September 24, 2011
Where:  Charles Koch Arena – Wichita State University – (southeast corner of 21st/Hillside)
Open to children from grades 3rd to 8th.
Please arrive between 9:00am and 9:30am for registration. Parent/guardian signature required to attend the event. The event is from 9:30am to 3:00pm. Please arrive at 3:00pm to pick up your child. We also will have a bus transportation to and from the event. Please contact Jennifer Wright at 337-6364 to schedule this.

Registration Form
 

Child's First Name:  

Child's Last Name:  

Grade in School:

Address:

City:

State:

Zip:

Parent's Information

Parent's Name:

Parent's Phone:

Address:

City:

State:

Zip:

Emergency Contact Information 

Emergency Contact:

Address:

City:

State:

Phone:

Any friends attending?

If Yes, please list their names: