Registration
Miss Ohio's Teen Tea Party Join Allie Gray, Miss Ohio's Teen, for a Tea Party. This event includes refreshments for each registered Tea Party guest, activities, open gym and picture time with Miss Allie. Proceeds from this event will be donated to Allie's American Heart Association Fund. Ages 3-10 years
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 Info (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Is your child potty trained? If they are not potty trained a parent must stay with them for the duration of the Tea Party.*
 
Additional Information:
 
Assumption of Risk
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I've read the above and agree.
 
Release of Liability
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I've read the above and agree.
 
Covenant Not to Sue
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I've read the above and agree.
 
Medical Emergencies
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I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
 
 
eCheck/Bank Draft:
Bank Name:
Bank Routing Number: (9-digit number)
Your Account Name: (Your name on your bank statement)
Your Account Type:   Account Number: