Kids Club Membership Form

TO REGISTER BY FAX OR MAIL: Click

TO REGISTER ONLINE: Complete form below and click submit button to e-mail your registration to the Lasers. If joining as a "Big Fan" or "Super Fan", once received, we will invoice you by mail for the appropriate membership fee.

* indicates required information

Select Type Membership:*		Fan-Free Big Fan-$10 Super Fan-$25
	Child's Name*	Age*
	Parent's Name*
	Address*
	City*
	State*	Zip*
	E-mail Address
	Day Phone*
	Evening Phone
	Mobile Phone
If joining by fax as a Big Fan or Super Fan member, please submit credit card information, or mail form with credit card information or enclose a check payable to: Springfield-Greene County Park Board, 1923 N. Weller, Springfield, MO 65803. If you have questions call 417-864-1339.
Parents billing address and name if different :
	Name
	Address
	City
	State	Zip

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