Lego Club 2025 Ages 5-10

Lego Club0- FALL 2025 - Ages 5-10

Every Tuesday, starting October 7 - November 25 4-4:45 pm
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Allergies
Parent/Guardian Name
Mobile Number
Phone Number
Work Number
Email
Photo Release Permission: This will allow staff take photos of the children during the program for promotion on our website and social media.
Signature

Clear
Should be Empty:

Lego Club0- FALL 2025 - Ages 5-10