2024/2025 Registration Form
Child's Information
Child's Name
*
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Copy of Birth Certificate (1st year students only)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
2 Year Old Options
Please Select
Monday, Wednesday, Friday - (Waitlist)
3 Year Old Options
Please Select
Monday, Wednesday, Friday (Waitlist)
Tuesday and Thursday (Waitlist)
4 Year Old Options
Please Select
Monday, Wednesday, Friday
Tuesday, Thursday, Friday
Monday, Tuesday, Wednesday, Thursday
Additional Children
Child's Name
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
Copy of Birth Certificate (1st year students only)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
2 Year Old Options
Please Select
Monday, Wednesday, Friday - (Waitlist)
3 Year Old Options
Please Select
Monday, Wednesday, Friday (Waitlist)
Tuesday and Thursday (Waitlist)
4 Year Old Options
Please Select
Monday, Wednesday, Friday
Tuesday, Thursday, Friday
Monday, Tuesday, Wednesday, Thursday
Additional Children
Child's Name
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
Copy of Birth Certificate (1st year students only)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
2 Year Old Options
Please Select
Monday, Wednesday, Friday (Waitlist)
3 Year Old Options
Please Select
Monday, Wednesday, Friday (Waitlist)
Tuesday and Thursday (Waitlist)
4 Year Old Options
Please Select
Monday, Wednesday, Friday
Tuesday, Thursday, Friday
Monday, Tuesday, Wednesday, Thursday
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Parents' Information
Parent/Guardian 1
Parent/Guardian 1
*
First Name
Last Name
Relationship to Child
*
E-mail
*
example@example.com
Cell Phone
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 2
Parent/Guardian 2
First Name
Last Name
Relationship to Child
E-mail
example@example.com
Cell Phone
Home Address Same as Parent/Guardian 1?
Yes
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Payment
You may also pay in-person, however your spot will not be held until payment is received.
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( X )
Registration Fee
$
50.00
Number of Children Registering
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
SUBMIT
Should be Empty: