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Your Name:
First: Last: Middle:
Address Line 1:
Address Line 2:
City: State: Zip Code:
Phone Number E-mail Address
Pay Pal Account E-mail Address:
Referred By (Please give name and e-mail address of the person who referred you)
If you have a coupon, please enter the code here:
On the card, who should we say the gift is from?
Does the family celebrate North American Holidays?
If you have a religion preference, please specify (we have some crafts available related to religion. Answer only if you wish to be included for these kits.)
Is there any other information you would like to give?
How did you find Krafty Kids Klub?
How many children will be included in this subscription to Krafty Kids Klub?
Please list each child individually. Each child on the same subscription MUST have the same address.
Child 1 Information
First Name: Last: Middle:
Is this subscription for a Boy Girl Birthday (mm/dd/yy)
Which subscription plan do you want for this child?
Starter $15.99 Basic $29.99 Deluxe $54.99
Favorite Color(s): Interests
When would you like the first craft kit to arrive? As Soon As Possible In Time for Birthday In Time for Christmas In Time for Other(please specify) January February March April May June July August September October November December
Child 2 Information (Please skip if you are not adding an additional child)
Starter $13.00 Basic $25.00 Deluxe $47.00
Child 3 Information (Please skip if you are not adding an additional child)
Child 4 Information (Please skip if you are not adding an additional child)
You may wait for e-mail confirmation and total before sending payment. If you wish to send payment now, please send payment through http://www.paypal.com The e-mail account to send payment to is: kraftykidsklub@representative.com. Thank you for your order!