2017 Krewe of Angels Registration Form

Mardi Gras Ball and Parade

in the Carencro Community Center

on Saturday, February 4, 2017

Mailing Address: P.O. Box 62613Web Address: kreweofangels.org

Lafayette, LA 70596Email Address:

Due to limited space, the ball and parade is open to the first 36 registration forms received.

Registration forms must be received no later than November 30, 2016.

Please Print

Participant’s Name ______

Diagnosis (optional) ______

Age ______Birth Month ______Male _____ Female _____

Will participant need a ramp to get on stage? _____Is participant on a soft food diet? _____

What size t-shirt does the participant wear? Please circle correct size

YOUTH: X-SM SM MED LG X-LG ADULT: SM MED LG X-LG 2X 3X

Parent/Guardian’s Name ______

Address ______

City ______State ______Zip Code ______

Home Phone ______Cell Phone ______

Registration forms must be received no later than November 30, 2016.

Formal or Sunday best for participant, casual wear for two complimentary guests.

Doors to Carencro Community Center will open at 5:00 p.m. The parade begins at 6:00 p.m.

Participant may dress in a costume or use a Mardi Gras mask to add festive fun to the Mardi Gras Parade! Expect a letter from us confirming receipt of registration within 7-10 days.

Responsibility, Photo, & Liability Release

I understand that an adult must remain with above named participant at all times and is responsible for the behavioral needs of participant for the safety of everyone. During the parade one adult must walk with above named participant. I understand that participation in the ball and parade gives the Krewe of Angels permission to use photos of participant to promote the Krewe of Angels. All participants will have their name posted on the Krewe of Angels website, ball program, and other forms of media. I hereby release the Krewe of Angels and all those affiliated with the Krewe of Angels from any liability. They will not be held responsible for any accidents or injuries that may occur at any Krewe of Angels event. Krewe of Angels reserves the right to ask anyone to leave due to inappropriate behavior.

Parent/Guardian Signature ______

Date Signed ______

Please see back of registration form…

------Office Use Only------

Rev. 4/20/16

Angel # ______Date Received ______Participant ______D & N ______

Please answer the following questions: (answers will be used when we present court)

What is your Angels favorite moment or character about our Wizard of Oz theme?

______

What are some fun things you would like to share about your Angel?

1-______

2-______

3-______

4-______

Choose one of the following titles or be creative maybe with a Wizard of Oz twist.

MaleFemale

KingQueen

PrincePrincess

DukeDuchess

EarlCountess

BaronBaroness

Jester Jester

Court JesterCourt Jester

Lady

Maid

AngelAngel

Your Angels Title for our 2017 event ______

Thank you 