Martha Burns Swimming School
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Birthday Party Form
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Birthday Party Information
* Parent Name:
* Address:
* City:
* Zip:
* Phone:
* Email:
* Child's Name:
* Child's Birthdate:
* Birthday Party Date (Sundays Only):
* Number of Kids (Including Birthday Child 1-14 = $275 ):
Select One
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Extra Kids ($15 each):
Select One
1
2
3
4
5
6
7
8
9
10
* Payment Method:
Select One
Check
Visa
Master Card
Discover
Credit Card # (eg: 0000 0000 0000 0000):
Name on Card:
Exp (eg: 01/2010):
Check Number:
Amount:
Date:
Comments:
Submit
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