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