Saturday, October 15th: 5:00 - 7:00 P.M. 
SEIU Local 668, 600 PENN AVE, WILKINSBURG, PA 15221 *Direct all questions to RaChelle: 412-201-4407
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Email *
NAME OF SEIU 668 Member *
Cell Phone Number *
Child #1: Name and Age
Child #2: Name and Age
Child #3: Name and Age
Child #4: Name and Age
Are you available to VOLUNTEER? *
1. This is an event for kids of ALL ages. 
2. The member must be in attendance and remain with their children through out the event.  Kids can not be left unattended.  
3. This is not a costume party. If the kids want to come in costume, they are welcome to do so! Adults, use proper judgement if you are dressing up, it's a party for the kids! 
4. A treat bag will be provided for all participants! 
*(Please monitor your children if they have allergies.) 
5. Members without kids are encouraged to attend with their fellow members, and use the event to socialize! 

If you or your child needs any accomodations, please list them here: 
Emergency Contact Name & Phone:
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