Friday Drop-In Registration Form

Registration- Friday, December 12

Fill out the form carefully for registration. Once registration is complete, an email will be sent to you detailing policies and procedures as well as payment procedures. Drop-in rates are $60 per child with a discount for more than one sibiling.
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail
example@example.com
Mobile Number
Emergency Number
Additional Comments (Please let us know any need-to-know information like allergies, etc.)
Should be Empty:

Registration- Friday, December 12