Maker Fun Factory VBS June 26-30, 2017 9:00 AM-12:15 PM
Child’s First Name:
Child’s Last Name:
Primary Contact Phone:
Date of Birth:
School grade completed June 2017 (select):
Person Completing This Form:
Person Picking Up Child:
Alternate Pickup Person:
Emergency Contact Name:
Emergency Contact Phone Number:
Allergies or Other Medical Conditions:
How did you hear about Maker Fun Factory?
Name of a friend child might like to be with:
Note: We will do our best to accommodate this, but cannot guarantee it.
Siblings attending Maker Fun Factory:
Your Email Address
Looking forward to having you with us!
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