Registration
Children will have fun participating in obstacle courses, Trampoline & Bouncy House, games & much more! Pizza & juice provided. Ages 3-12 6:30-9:30 PM $20 Members $25 Non-Member NO WALK INS! *Must be potty proficient
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
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Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
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Address: *
City: * State: * Zip: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Phone number you can be reached at during PNO event?*
 
Additional Information:
 
RELEASE LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY
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PARENTAL CONSENT
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MEDICAL EMERGENCY
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PAYMENT POLICIES FOR EVENTS
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Enter your Full Name: *   
 
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Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
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City: State: Zip:*