Registration Form
Kindly complete an additional form if more than one child is attending.
Father
First Name
Last Name
Mother
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number Parent 1
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number Parent 2
Please enter a valid phone number.
Format: (000) 000-0000.
Email Parent 1
example@example.com
Email Parent 2
example@example.com
Approved Family members:
To pick up and drop off, please bring proof of identification
Child's Name
First Name
Last Name
Age and Grade level
Please ensure all information is correct.
Please include information about the child
example: any known allergies, food preference i.e.
My Products
*
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Registration Fee
At this time we do not accept any refunds.
$80.00
$
80.00
Signature
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