Holiday Fun Camp – Heidi Lifrage

Contact:
321-277-5819
heidi@heidilifrage.com
http://www.heidilifrage.com

Participant Information
Full Name*
First Name Last Name
Birth Date*
Date Format: YYYY slash MM slash DD
Current Grade*
Household / Adult Primary Contact
Parent Full Name*
First Name Last Name
Relationship to Participants*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email Address*
Emergency Contact
Emergency Contact Full Name*
Emergency Contact First Name Emergency Contact Last Name
Emergency Contact Details*
Emergency Contact Phone Relationship to Child
Product Name
Jingle Workshop
- Dec 23st 12:30pm-3:30pm $50 each day
- Jan 6th 12:30pm-3:30pm $50 each day
Dec 23st 12:30pm-3:30pm
or
Jan 6th 12:30pm-3:30pm
Enders Park Clubhouse at Baldwin Park
947 Fern Ave Orlando FL 32814
$50 Each Day, includes Supplies
Total
$0.00
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Participant Information