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 9:30-10:00
Monday 10/19 9:30-10:00
Monday 11/2 9:30-10:00
Monday 11/16 9:30-10:00
Monday 12/7 9:30-10:00
Monday 12/21 9:30-10:00
Monday 1/4 9:30-10:00
Monday 1/18 9:30-10:00
Monday 2/1 9:30-10:00
Monday 2/15 9:30-10:00
Monday 3/1 9:30-10:00
Monday 3/15 9:30-10:00
Monday 4/5 9:30-10:00
Monday 4/19 9:30-10:00
Monday 5/3 9:30-10:00
Monday 5/17 9:30-10:00
Signature
Submit
Should be Empty: