Jene Beauty
Mommy + Me Lipgloss Workshop
Parent/Guardian Full Name
*
First Name
Last Name
Parent Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child’s Name
*
First Name
Last Name
Child’s Age
*
Does your child have any allergies or sensitivities?
*
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I give permission for my child to be photographed or video recorded during the event for promotional use?
*
Please Select
Yes
No
I understand that all payments are FINAL and my spot is only secured once payment is complete
*
Yes, I understand
Signature
My Products
*
prev
next
( X )
Mommy + Me Ticket
A Fun Bonding Experience For Moms & Their Little Ones (Ages 4-15)
$35.00
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Additional Child
Purchase for each additional guest
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
Submit
Should be Empty: