Wufoo

INFORMATION
1. Check-in will begin at 6:00pm.
2. Parents will be asked to sign a waiver before leaving their child.
3. Children will be fed pizza and popcorn.
4. If there are any allergy or other issues, please let us know below.
5. Children can be from ages six weeks old through 5th grade.
6. All children must be picked up before 9:00pm.

DATE/TIME
Saturday, February 18, 2012 - 6:00-9:00pm

ADDRESS
Oak Leaf Church
151 East Marietta St
Canton, Ga 30114

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Name * First Last
Email *
How many children will you be bringing? *
1 2 3 4 5 more than 5
What are the ages of the children? *
younger than 1 1 2 3 4 5 6 7 8 9 10 11
Are there any allergies or other issues we need to be aware of?
In case of emergency, what number is best to reach you? * ### - ### - ####
In case of an emergency, where will you most likely be? *
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