Finding Nemo Homeschool Production
Complete the form to register your child for the enrichment class.
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian 2 Name
First Name
Last Name
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name if parent contacts cannot be reached
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Any Allergies or Medical Conditions?
Tuition Payment
*
prev
next
( X )
Finding Nemo Production - pay in full
Mondays 12:30-2:00
$225.00
$
225.00
Finding Nemo Production - 3 monthly payments
Mondays 12:30-2:00
$75.00
$
75.00
Credit Card
Register
Should be Empty: