TDC Community Connections
Student Information
STUDENT Full Name
*
First Name
Last Name
Student Age
*
age
Birthdate
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Gaurdian
*
E-mail
*
example@example.com
PLEASE NOTE: Any no-shows or cancellations within 24 hours will not be refunded.
Story Time With A Twist
Monday 10/5 11:30-12:00
Monday 10/19 11:30-12:00
Monday 11/2 11:30-12:00
Monday 11/16 11:30-12:00
Monday 12/7 11:30-12:00
Monday 12/21 11:30-12:00
Monday 1/4 11:30-12:00
Monday 1/18 11:30-12:00
Monday 2/1 11:30-12:00
Monday 2/15 11:30-12:00
Monday 3/1 11:30-12:00
Monday 3/15 11:30-12:00
Monday 4/5 11:30-12:00
Monday 4/19 11:30-12:00
Monday 5/3 11:30-12:00
Monday 5/17 11:30-12:00
Signature
Submit
Should be Empty: