Phone # (                   ) ________________________________

Email ____________________________________________________________________________

Children Name                                            Age              Adoptive Country/ or Biological

___________________________________     ______          __________________________________

___________________________________     ______          __________________________________

___________________________________     ______          __________________________________

___________________________________     ______          __________________________________

___________________________________     ______          __________________________________

___________________________________     ______          __________________________________

Guests Attending 

Name   ________________________________________

            ________________________________________

$15.00 per family for Park Building costs and Event Insurance.  Please pay by check to
Children's Hope International
Att. Gloria
11780 Borman Drive
St. Louis, MO 63146.

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