Registration
Splish Splash! FUn night is hosted at our Umatilla location. Dancing, Games, Crafts and Snacks! Bring Pajamas, sleeping bag and pillow if staying all night! Eat dinner before you come, snacks served late. Please Indicate in the comments section if you are staying all night or picking up at midnight, so that we may charge your account accordingly. 8pm-midnight: $15 8pm-8am: $25
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*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*