Let's Pretend Tea Parties -

PLEASE NOTE:
If registering more then one, We will combine your total into one transaction.

# of Participants:
Name or Names of participants:
Parent/Guardian:
e-Mail:
Phone:
Upcoming Event:	or
Weekly Event:
Secured Credit Card Payment Processor
Credit Card:
Card Number:
Expiration Date:
*Card Security Code:
Card Holder:
Address for Card: