EmailMe Form - Highland Lake Picnic Registration Form

Name *
First Last
Address *

Street Address City State / Province / Region Postal / Zip Code
Day Time Phone *
### - ### - ####
Email (will not be shared or published) *
Retype Your Email Address Below

Confirm Email Address
Number of Picnic Attendees (Including Yourself) *
How many attendees will participate in the games *

2 - 5 year olds

6 to 8 years olds

9 to 11 year olds

12 years to Adult
How many will join our chicken dinner. *

Children

Adults
Comments
Should you have any question please type it in above

Children
Adults