Creative Play: Even Superheroes Have Bad Days: Understanding Big Feelings (PreK3 & PreK4)-PWYC

Creative Play: Even Superheroes Have Bad Days: Understanding Big Feelings (PreK3 & PreK4)

Registration Form
Student Information
Student Name*

First NameLast Name
Student Age*
Parent Email*
example@example.com
Student Birthday*

MonthDayYear
Date
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent Information
Primary Parent Name*

First NameLast Name
Primary Parent Cell Phone Number*

Area CodePhone Number
Secondary Parent Name (optional)

First NameLast Name
Secondary Parent Email
example@example.com
Secondary Parent Phone Number

Area CodePhone Number

Please make sure your child is available for all dates and times listed below:

Saturdays, 10 AM-11:30 AM

Dates: February 15, 22, March 1, 8, 15, 22, 29, April 5 (8-week)
Signature

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This class is "Pay What You Can" as part of our Community Wellness Program

Pay-What-You-Can (Full tuition=$300)

USDEnter Class Tuition Amount

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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