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Club 345 – Trampoline Takeoff Sky Zone September 29, 2024
ALL TIOH 3rd – 5th Graders! Join us for a fun afternoon at Sky Zone Van Nuys!
September 29, 2024
12:00-3:00pm – pizza lunch will be provided!
Child Name
(Required)
First
Last
Child Date of Birth
(Required)
MM slash DD slash YYYY
Child Grade
(Required)
Third Grade
Fourth Grade
Fifth Grade
Allergies/Dietary Restrictions
We will be providing cheese pizza, chips, and Capri Sun
Parent Name
(Required)
First
Last
Parent Phone Number
(Required)
Parent Email Address
(Required)
Emergency Contact Name
(Required)
First
Last
Emergency Contact Cell Phone Number
(Required)
(Required)
I acknowledge that TIOH is only providing transportation to Sky Zone, meaning I am responsible for picking up my child at 3:00PM from Sky Zone Van Nuys located at: 7741 Hayvenhurst Ave Van Nuys, CA 91406
Who will be picking up your child?
(Required)
Me
Someone Else
Authorized Pick Up Name
(Required)
First
Last
Authorized Pick Up Cell Phone
(Required)
Registration Fee
Amount:
cc fees
I wish to cover credit card fees for the temple by increasing my total by 3%
Credit Card Fees
$0.00
Total
Credit Card
(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
Security Code
Cardholder Name
Billing Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
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Montana
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New Jersey
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New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
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Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
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Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
PLEASE NOTE: Two waivers will be sent to the email address you listed above. Registration will NOT be complete until these two waivers have been submitted.
(Required)
I acknowledge that registration is not complete until these waivers have been submitted.
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