Bilingual Kids registration

Lifetime Montessori After School Spanish Club

Wednesdays, January 11, 2023 to February 15, 2023, 3pm - 4:15pm
Student's Name

First NameLast Name
Grade and Age

GradeAge
School Name
Homeroom
Language Proficiency Level
Has your child enrolled in our programs before?
Please describe area where your child needs most support with language learning.
Special Instructions? IEPs (Please be specific), Allergies, etc..
Parent Name

First NameLast Name
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent E-mail
example@example.com
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Additional person authorized to pick up my child

NamePhone number
How did you hear about us?
Photo/Video Release
Parent/Guardian Consent
Parent/Guardian Signature

Lifetime Montessori After School Spanish Club

Wednesdays, January 11 to February 15, 3pm - 4:15pm

$210.00 Quantity

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Payment Methods

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Lifetime Montessori After School Spanish Club