Cookies & Cocoa- Newport Beach
Sunday, Dec 15th
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Child's Name
*
First Name
Last Name
Child's DOB
*
-
Month
-
Day
Year
Date
Sibling
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Timeslot
*
9:45 -10:45am
11:00-12pm
Payment (NO refunds or credit)
*
Please Select
Charge my CC on file and email me a receipt
Call me to pay over the phone
$25 members/siblings $10
$30 non-members/siblings $15
*NO CREDITS OR REFUNDS*
Submit
Should be Empty: