*Parent's Night Out*
Saturday, July 16th 6 to 9 PM LEGO Party - Games, Challenges, Pizza Held at Art and Company 7335 82nd St
Name of Child
*
First Name
Last Name
Age
*
Name of 2nd Child
First Name
Last Name
Age
Name of 3rd Child
First Name
Last Name
Age
Name of 4th Child
First Name
Last Name
Age
Name of Parent/Guardian
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Phone Number
*
-
Area Code
Phone Number
Name of Additional Emergency Contact
*
First Name
Last Name
Relation to Child
Phone Number of Additional Emergency Contact
*
-
Area Code
Phone Number
Allergies, Medications, Other Medical Alerts or Concerns
Pizza (click "Other" if Your Child is Allergic)
*
Cheese
Pepperoni
Either
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