Saturday, October 15th: 5:00

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Saturday, October 15th: 5:00 - 7:00 P.M.

SEIU Local 668, 600 PENN AVE, WILKINSBURG, PA 15221 *Direct all questions to RaChelle: 412-201-4407

Email *

NAME OF SEIU 668 Member *

SHOP *

Cell Phone Number *

Child #1: Name and Age

Child #2: Name and Age

Child #3: Name and Age

Child #4: Name and Age

Are you available to VOLUNTEER? *

Please add me to be on the "Halloween Party Committee"

I can help decorate the week before the event!

I can help the day of the event to set up!

I can help during the event!

I can help with clean up!

I will donate CANDY for the event! (Encourage your shop members to send some too!)

I can dress up as a Ghost or Goblin for the Haunted cublicle part of the event!

Required

1. This is an event for kids of ALL ages.

2. The member must be in attendance and remain with their children through out the event. Kids can not be left unattended.

3. This is not a costume party. If the kids want to come in costume, they are welcome to do so! Adults, use proper judgement if you are dressing up, it's a party for the kids!

4. A treat bag will be provided for all participants!

*(Please monitor your children if they have allergies.)

5. Members without kids are encouraged to attend with their fellow members, and use the event to socialize!

I understand that the member must remain with their children at all times.

Required

If you or your child needs any accomodations, please list them here:

Emergency Contact Name & Phone:

Send me a copy of my responses.

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