PNO Info page

FILL OUT FORM BELOW TO COMPLETE REGISTRATION

* Indicates required field

Parents Name *

First

Last

Email *

Phone Number *

I understand my child cannot wear Sandals at the homestead *

Yes

I understand I need to pay 1/2 deposit to secure a spot and my deposit is non refundable if I cancel *

Yes

I understand I will be charged $10 per child each additional 15 minutes after Pick up time (830-845 pm) *

Yes

Allergies *

List additional children here if more then 3 *

My child(ren) can participate in smores if we do a open smore fire *

YES NO

I have read the waiver and will bring a signed hard copy at drop off *

Yes

How can we contact you!! *

Text Email TEXT AND EMAIL

CHILD NAME 1 *

First

Last

CHILD NAME 2 *

First

Last

CHILD NAME 3 *

First

Last

Submit