MSMD Program Registration

Child's First Name *

Child's Last Name *

Child's Age *

Street Address *

City *

State *

Zip Code *

Parent Phone Number *

Parent/Guardian Name *

Parental Consent Form is signed & on file.

Yes

Parent Email. PLEASE ensure this is correctly filled out so that you can receive any last-minute important notices/information/updates about the party, program/s, camp/s for which you are registering.

Email Address *

If you have a 2nd child attending the same camp or enrichment program, please note it below and we will process their registration with a 20% sibling discount.

Comments: *

2020 Programs include:

2020 Princess Tea Parties
1st (and somtimes 3rd Saturday) of each month, 10:30-11:30am. Reservation confirmed with payment. Designed for ages 3 and up. Limit 16 guests per party. $20, includes FREE book. Please arrive promptly.

Current Total:

$0.00

This registration form requires a credit card regardless of cost of event. For FREE events, your credit card simply secures your spot. It will NOT be charged.

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

3-digit CVV code (found on back of card.) 4-digit for Amex. *