Summer Tots Waitlist Payment Form Summer Tots Waitlist Payment Form (8.29.21) Name* First Last Email* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*How many tickets would you like for adults? Quantity Price: $12.00 Quantity How many tickets for children over the age of 12 months? Quantity Price: $12.00 Quantity Would you like to add a "Let's Get Silly" Activity Book to your order for $5?No, I do not want an activity bookAdd oneAdd twoAdd threeAdd fourCover the Credit Card Fees Would you like to donate the credit card fees? Credit Card Fees Donation Price: $0.00 Total $0.00 Credit CardCard Details Cardholder Name EmailThis field is for validation purposes and should be left unchanged.