Registration

Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Name and Phone Number (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
How many people (including yourself) will be attending?*
Which project would you like your child to create? (Please select one) 1. Personalized Heart Keepsake – $20 2. Fridge Magnet Picture Frames (2) – $20 3. Painted Flower Cut-Outs (2) – $20*
Please describe how you would like your project personalized: (Examples: names of children or message for mom)
I acknowledge that an adult is required to remain with the child for the duration of the workshop.*
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification: