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Churches Outreach
Saturday, July 25, 2025
9am-6pm
Waterbury, Connecticut
REGISTRATION
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Your Name prefix, Mr or Mrs?
First name *
Last name *
State/ Province *
City/Town *
Telephone
Primary E-mail (for event reminders or changes) *
Church name (if any)
Attending *
Online (Fri., July 25, 2025)
Waterbury (Sat. July 26, 2025)
How many adults? *
Other adult(s) first and last name(s):
Students attending with you: (Name and upcoming grade level is required for back to school and other giveaways)
How many children are attending with you? *
Student 1 first and last name
Student 2 first and last name
Student 3 first and last name
Any Other Student name(s) here:
Age Group (select all that apply) *
Not Applicable
2-5 years
6-10 years
10-13 years
14-17 years
18 and over
Grade (select all that apply) *
None
K
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Needs (Check all that Apply) *
Food (local only)
Back to School Supplies
Other Resources Help (local only)
I'm All Set
Any other special considerations?
Verification Code *
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