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October 5
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Superheroes Special Needs Saturday
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Special Needs Superhero Application
Saturday, October 5, 2024 - 4:00pm - 6:30pm
This event is free to children and adult with special needs as well as their family and caregivers.
Register by September 13th and receive a free t-shirt.
If you have any questions about the application, please contact Pastor Tim Reynolds at
618-315-1111.
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
E-mail Address:
T-Shirt Size:
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Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Emergency Contact Phone:
CILA Home (if applicable):
Special Accommodations:
Additional Relevant Information:
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