Paint N Sip Registration

Beacons Paint n Sip Registration

* Indicates required field

Name *

First

Last

Which Beacons center are you or is your young person connected to? *

How many paint kits will you need? *

1 2 3

We will provide snack packs. Are their any special dietary needs that we should be aware of? *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Thank you, is it ok to text this number? *

Yes No

Submit