STEAMULATION LAB

booking events

Child's First Name

Child's Last Name

Child's Date of Birth

Child's School Grade

Gender

Female

Male

Prefer not to say

Please Describe any Food Allergies

Parent/Guardian's Full Name

Parent/Guardian's Phone Number

Address

Do you want to be notified about upcoming programs?

Yes

How did you hear about us?

I agree with the terms

To secure your booking, it is required to make a deposit of $40.
Please e-transfer the fee to info@steamulationlab.com to complete your registration.

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