Public Session Request

Today's Date

Your Name

First time at KAH? Yes No

E-Mail

Phone

Are you registering for a group? Yes No

If Yes, name of your group & address

Number of children 0-7

Number of children 8-12

Number of teens 13-17

Number of adults 18+

Total number of people

Date Requested

Time Requested AM PM

Will you help financially? Yes - We want to help No - We cannot help right now

Do you need help with fund raising? Yes - Please contact me Maybe - May request help later No - We are already raising funds!

How did you learn about us? Served before Friend told me Internet search Newspaper or TV story Drove by My employer

Comments or Questions