15479 Clayton Road, Ballwin, MO 63011   -  636-207-7405 - Fax 636-207-7407
www.worldways.org   (email) worldways@sbcglobal.net

Birthday Registration Form
We are delighted that you chose Worldways Children's Museum as the place to have your child's birthday party. Please complete this form and mail it back to us with your deposit for $________.

(*) Family Name ____________________________________________________

(*) Birthday Child's Name ____________________(*) Age______ Boy___ Girl___

(*) Party Package   International Games ($25.00 deposit)
                              Lost Treasure Trek ($50.00 deposit)
                              Josephina's Fandango ($50.00 deposit)

(*) Date of Party ____________________(*) Scheduled Time __________________

(*) Contact Parent's First Name ___________________________________________

(*) Complete Mailing Address_____________________________________________

____________________________________________________________________

(*) Daytime Phone (_____)______________ Home Phone (____)________________

(*) Email Address______________________________________________

Form of Payment:   Cash    Check (payable to Worldways Children's Museum)
                                 Charge       Visa      Mastercard    Other__________

            Card #___________________________ Expiration Date________

            Signature _____________________________________________
(*) Please complete all required fields
©Worldways Children's Museum - 04/2005