Easter Booking – STEAMULATION LAB

Email

Child's First Name

Child's Last Name

Child's Date of Birth

Child's School Grade

Gender

Female

Male

Prefer not to say

What time would you like to register?(date: February 8th)

10:30am-11:30am

11:45am-12:45pm

How many people will be participating?

Only child

One Parent

Both Parents

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

No

How did you hear about us?

I agree with the terms

To secure your booking,
Please e-transfer the fee ($25) to info@steamulationlab.com to complete your registration.

Credit Card Payment can be made through this link: