Riseup PreregistrationRiseup Pre-registration Pre-register for our family Riseup Event on April 19th, 2019Parent/Guardian InformationName* First Last Email Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mobile PhoneDo you Attend Church?yesnoIf you do attend church, where do you attend?Kid's InformationTell us about your kid*First NameLast NameAgeGrade (hit the plus sign to add additional children)What time would you like to attend?*6:00-6:306:30-7:00 (FULL - Choose another time if possible)7:00-7:307:30-8:008:00-8:30We will do our best to get you started at your requested time. We will use this information to help us better plan the event.At the end of the event, your family has the opportunity to have a family picture taken free! Click here if we have your permission to take a photo.*yesnoCommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.