Who I Am Questionnaire

Please fill out our Who I Am questionnaire to help us learn about your daughter's preferences and any special needs.

Child's First Name *

Child's Last Name *

Parent First Name *

Parent Last Name

Emergency Contact for day of the event if different than Parent listed above

Emergency Contact Phone *

Parent Email *

List activities and hobbies you are involved in: *

Favorite song: *

Favorite color: *

Favorite book or author: *

Empowering Word (to be included in your portrait if you choose): *

Favorite type of pizza: *

Cheese only

Hamburger

Veggie

Pepperoni

Please list any food allergies we need to be aware of: *

Will your daughter be attending with a friend? If so please list her friend's name(s). We will do our best to keep you in the same group. *

Name to appear on nametag (we will just use first names): *

Street Address *

City *

State *

Country

Postal code *

Radio 718l

Youth Small

Youth Medium

Youth Large

Adult Small

Adlult Medium

Adult Large

Adult XL

Adult XXL

T-shirt Size *