Youth Pizza Party Breakout

Date & Time: August 31, 2024 from 11:30 am - 12:30 pm

Location: CiCis Pizza

655 W Illinois Ave Bldg 200 B-102 & B-104,

Dallas, TX 7522

Youth Leaders: Lelia Adekunle & Christina Grimes

For questions Contact: 469.224.7444

For youth under 18, please complete the form below and submit it no later than August 28th. Without a registration/permission form on file, your child will not be able to attend the event.

Youth Pizza Party Form

Name of Teen/Youth

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Any food alergies?

If yes, please provide additional details and instructions below.

By providing your name below and submitting this form, you grant permission for the child's name listed on this form to attend the Youth Pizza Party Breakout on August 31, 2024.

Youth Pizza Party Breakout

Compel City Community Church