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2. Bingo with Badges

   Please complete the online form below to register for Bingo with Badges. Although this is a FREE community event, space is limited to 75 participants. Once spots are filled a waiting list will be established. If you would like to contact us by phone, you may call (713) 668-0330.

4. First Name*
5. Last Name
7. Address1*
9. Address2
11. City
12. State
13. Zip
15. Email *
16. Number of Participants *
    -- Select One --123456
18. Parent or Gaurdian Acknowledgement *

    1. I Agree

    To ensure the safety of all participants, parent/guardian participation is required throughout the duration of the event.

Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit Submit and Print

* indicates a required field