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August 10-14, 2014

6:00-8:30 p.m.

Please register using the form below. You will need to fill out a separate registration for each child.

If you have any questions, please email at or call at 734-362-7300.

Child's Name *
Child's Name
Gender *
Birthday *
Phone *
Parent/Guardian Name *
Parent/Guardian Name
Emergency Contact
Emergency Contact
Emergency Phone
Emergency Phone
Food Allergies *
Medical Concerns? *