Payment Form - We Rock x Friendship

Full Name*
First Name Last Name
Phone Number*
Is this your first time at Friendship Circle? We're so glad you can make it! *

YesNo
How many children are attending in your group?*
How many of those children are under age 9? Please note, this event is for ages 2-10.*
How many adults are attending in your group?*
I understand that this is not a drop-off program and I must be present to supervise my child during the event.*

Yes, I understandNo

Payment: $10/child. Additional donations appreciated. $36 donation for sponsorship.*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

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