Course Registration Form

Registration Form

Fill out the form carefully for registration
First Child*

First NameLast Name
Second Child`s Name

First NameLast Name
Child #1 Birth Date*

MonthDayYear
Child #2 Birth Date

MonthDayYear
Gender of Child #1*
Gender of child #2
Grade in Sept 2023 (First Child)*
Grade in Sept 2023 (Second Child)
What program do you want to sign up for? Week 1 is $239 and Week 2 is $319*

Week 1 Harry Potter Winter Camp (Dec 27-30)Week 2 Winterlicious Camp (Jan 2-6)
Do you need Lunch to be provided? (Per Child, Per day)*

Lunch ( +$30 week 1)Lunch ( +$40 week 2)
Do you need Before Care? 8am-9am? What days? ($6 a day)*

MondayTuesdayWednesdayThursdayFridayAll weekDon't Need
Do you need After Care? 4pm-6pm? What days? ($ 10 a day)*

MondayTuesdayWednesdayThursdayFridayAll weekDon't need
Food and other allergies, Medical Conditions *
Parents Information
Parents Name*

PrefixFirst NameLast Name
Parent E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Newsletter Consent*

I, Parent/Guardian of the designated student(s) listed for registration, do hereby give my consent to receive Jolly Jolly Arts and Reading Newsletters. I understand I can withdraw my consent at any time (Please see the Jolly Privacy Policy for more details).
Terms & Conditions
Please click yes if you WILL give permission to have photographs taken of your child(s)*

YesNo
Terms & Conditions*

I agree to the terms & conditions set up by Jolly Jolly Arts & Reading
How did you hear about us?*
Additional Comments
IMPORTANT: This form simply accepts your registration information. It is not a confirmation of guaranteed enrollment, as spaces in our class and camp programs are limited. We will contact you within two business days to communicate if your desired session is available. If it is, we will formally confirm your registration and send you the program information packet and payment link. Thank you for your attention.
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Registration Form

Parents Information

Terms & Conditions