Participant                                                                                             age                or adult   

 

Address                                                                                      City                               Zip                 

 

Phone:  home                                      work mom                             work dad                 

 

Parent’s Names                                                                                                 e-mail                                     

 

Activity Name                                       Day                  Time               Starting              Fee paid         

 

___check enclosed  OR VISA card number                                                             exp.             ____sign below

 

 

Would you be willing to volunteer here?­­­________ Any special skills?________________________________

 

In consideration of your accepting my entry, I hereby, for myself, my child, my heirs, executors and administrators, waiver and release any and all rights and claims for damages I or my child may have against Creative Spark and its representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by this group.

 

Signature                                                                                             Date                                    

 

MAIL TO: CREATIVE SPARK, 757 LONG POINT RD., MT. PLEASANT, S.C. 29464

OR

FAX TO: (843) 881-8487

OR

OR REGISTER BY PHONE: (843) 881-3780

 

Note: Do Not Send As An E-mail Attachment  (Not Secure)

Your canceled check or credit card statement is your receipt and confirmation.