The deadline for registration for fall programs (excluding tutoring) is August 31st.
Please complete the following form and a representative will contact you shortly.
Parent's Name
Address (Street, City, State and Zip)
Names and ages of all participating children
Home Phone Number
Work Phone Number
Cell Phone Number
Email Address
Please select all that apply.
Please list any know allergies (If more than one child, be sure to indicate who has the allergy)
Primary Care Physician and Hospital (please include phone number and address)
Please list two (2) Emergency Contacts (Name and Phone Number)
Please list 2 Adults (Legal First and Last Names) that may sign your child in/out of a program session.
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