2026 Winter/Spring Little Tykes Form

215 Boulevard, Mountain Lakes, NJ 07046 | (973) 263-1818 | fax (973) 331-9459 | theacademy@optonline.net | www.theacademyforchildren.org
Winter/Spring 2025 Little Tykes Registration Form

Thursdays, 9:15am -10am January Thru May
All DatesJan 8Jan 15Jan 22Jan 29Feb 5Feb 12Feb 26Mar 5Mar 12Mar 19Apr 2Apr 16Apr 23April 30May 7May 14
Please email: theacademy@optonline.net for application!
Child's Name
Parents' Names
Adult responsible for/and attending with child, and relationship to child
Mom's Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
Dad's Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any known allergies yesno if yes describe
Childs Date of Birth

MonthDayYear
Date
Parenting topics you would like to discuss
Should be Empty:

Winter/Spring 2025 Little Tykes Registration Form