Jingle Bell Lock In

Welcome to our annual Jingle Bell Lock In!

Our event will be on Friday, December 19th, from 6:00PM to 8:30PM.

We are located in The Circle PGH at 230 Lincoln Avenue, Bellevue, PA 15202.

Doors to this event will open ten minutes prior to the start. You will escort your child inside to the ballroom where you will sign your child in and drop them off with the front desk greeter.

Doors to this event will lock promptly at ten minutes after the start. If you arrive late, please call or text the JP Gallery at 724.462.4548. The safety of the children are our number one focus. The Gallery will be secure during this event with chaperones in place.

Pizza dinner and snacks will be served along with bottled water. If your child has a food allergy, please list the details below and send them with a bagged meal if you are more comfortable doing so.

Students will eat, play games, and create a special homemade gift that will be wrapped and sent home for their families.

When the workshop is complete, all students will wait in the ballroom and will not be dismissed until the parent/guardian comes to the door to sign them out.

Please complete this registration form in its entirety, ensuring that all contact information is correct.If you have more than one child participating, please create a new form for each child.

All participants must be between the ages of 5 and 12 years old to attend.

Child's Name

First NameLast Name

Child's Date Of Birth

Date

Parent/Guardian Name

First NameLast Name

Parent/Guardian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact (To be called when the parent/guardian is not in reach.)

First NameLast Name

Emergency Contact Phone Number (To be called when the parent/guardian is not in reach.)

Please enter a valid phone number.Format: (000) 000-0000.

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Please list all allergies that we should be aware of. If none, simply write *none*.

I give my child permission to participate in the Jingle Bell Lock In sponsored by the JP Gallery For Performing Arts. The information I have provided on this form is most accurate and to the best of my knowledge. I hold harmless the JP Gallery For Performing Arts for any and all injuries that may be sustained from participating in this event. Everyone attending does so at their own risk.

I understand that all sales are final and can not be reversed once submitted. There are no refunds to this event.

Signature

My Products

1 Child Admission Jingle Bell Lock In

Admit 1

$48.00 Quantity
Item subtotal:

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Jingle Bell Lock-In 2025

My Products