Kids Movie Night Registration Form

"*" indicates required fields

Payments

-$65 first child • $55 each sibling

- Fees are 100% refundable when the program is canceled by the Department.

- Unfortunately, we are unable to offer refunds or in-store credit for cancellations made within 72 hours of your movie night start time.

Number of Kids*

Kid Full Name*

Age*

Date of Birth*

Second Kid Full Name*

Age*

Date of Birth*

Third Kid Full Name*

Age*

Date of Birth*

KIDS MOVIE NIGHT (Credit Card Price)

Price: $67.92

KIDS MOVIE NIGHT

Price: $65.00

Pick Your Date*

Parent Name*

Phone*

Email*

Address*

Street Address City State ZIP Code

Allergies*

Any Other Info

Full Name*

Phone*

Relationship*

Signature*

Initial*

Date*

Choose payment method below*

A 4.5% fee will be applied to all of your Credit Card Transactions.

Credit Card

Zelle

Total

Credit Card