Wednesday Night Activities
This information will be used to communicate with the parents about what we do each Wednesday night.
Wednesday night Registration
Pre-School through 5th Grade Registration
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Child's CURRENT grade (for the 2022-2023 School Year)
*
Pre-School
VPK
K
1st
2nd
3rd
4th
5th
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
-
Area Code
Phone Number
Alternate Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Please list any allergies your child may have:
*
Submit
Should be Empty:
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