Services
Children’s Mental Health
Teen Mental Health
Drug & Alcohol Treatment
Domestic Violence Program
Community Outreach
PEARLS for Seniors
FAQs
About
Our Story
Our Board of Directors
Our Leadership Team
Professional Associations
Our Values
Quality Improvement
Celebrating Individuality & Different Perspectives
Support Us
Holiday Giving
Ways to Give
Hearts for Heroes
Corporate and Foundation Partners
Volunteer
Events
Taste of the Town
Bingo Night Fundraiser
Board Installation & Awards
50th Golden Legacy Anniversary
5K Walk for Domestic Violence
Connect
Seeking Services
Client Support
Press
Newsletters
Impact Reports
Rent our Education Center
Request For Quote
Join Our team
Training Program
Careers
Contact
Donate
Get Help
Power Up & Glow Registration
Participant Full Name
(Required)
Age
(Required)
Gender
School Name
Parent Guardian Full Name
(Required)
Phone Number
(Required)
Alternate Emergency ( Full Name, Relationship to the Student, and Phone number)
(Required)
Email Address
(Required)
Home Address
(Required)
I have made arrangements for drop-off/pickup for my child
(Required)
Yes
No
Drop-off and Pick-up Arrangements (How is the student being transported for both pick up and drop off)
(Required)
Please list any food allergies.
(Required)
Do you have any medical history we should be aware of?
(Required)
Media Release
(Required)
I give permission to use my child's image for photos/media use
I do not give permission
Shoe Size for Bowling Rentals
(Required)
“I understand and agree to follow event rules and expectations”
(Required)
Stay for the full duration of the event 5 - 8pm
Follow all bowling alley rules
Follow instructions from all staff
To conduct myself in a respectable manner
Do you have parent/guardian consent to participate in this event?
(Required)
Yes
No
Menu
