Name *

Your Name

First Name

Last Name

Phone *

(###)

###

####

Childs Name *

Your child's name(s)

First Name

Last Name

Date of birth *

MM

DD

YYYY

Gender *

Male

Female

Sibling Name

First Name

Last Name

Sibling Date of birth

MM

DD

YYYY

Gender

Male

Female

Which Session(s)? *

Please select one of the options above.

Session I

Session II

Both

Dinner *

Please feed my child

I will pack my child's dinner

Preferred Method of Payment

Credit Card

Cash

Check