When: February 13th, 2021 Time: 6:00 pm- 10:00 pm Activities: Bounce House, Valentine Crafts & Fun Food: Pizza Pre-register by end of day 2/12: $25 2/13 (day of): $30 Payment is required at time of sign-up Ages 3+, must be able to use the bathroom independently Spots available: 25 Please call the office if there is any question as to the number of spots available.
Start Date/Time: End Date/Time:
Fee per Student: Room:
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Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info*
Students entered below will be added to your family's account
Cheese Pizza?*
Pepperoni Pizza?*
Additional Information:
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Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
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