Lotta's Birthday Club Form
Your Name
Parent's Name
Address #1
Address #2
City
State
Zip Code
Country
Email
Select:
Boy
Girl
What is your age?
Birth Date?
Day
Month
Favorite Color?
Favorite Hobby?
Favorite Toy?
Favorite Cartoon?
Enter A Question for Lotta The Clown:
If you cannot email this form, then print and send to
Lotta The Clown
PO Box 204
Canby, OR 97013