Student's Full Name *

First *

Last *

Student's Age *

Parent or Guardian's Full Name

First Name *

Last Name *

Parent or Guardian's Phone *

Parent or Guardian's Email *

Address

Street Address *

You agree to drop off your daughter to the event and pick her up on time

Yes, I agree

Do you consent to the use of photos and videos from this event for Mozaic's marketing and promotional materials?

Yes, I agree

No, I don't

Mozaic Girls Youth Club Presents: Stitch & Style: Crochet for Girls *

Price: $10.00

Commitment Fee. Youth will meet for 3 crochet classes and 1 picnic. Only for female youths ages 12-18.

Square *

Card *