First Child Name:
Date of Birth:
Gender:
Parent/Guardian Name:
Home Address:
City/State/Zip:
Phone Number:
Email Address:
Does your child have any allergies or medical conditions? If yes, please explain:
Do you want to include other child in your family?
Second Child Name:
Date of Birth:
Gender:
Does your child have any allergies or medical concerns? If yes, please explain:
Do you want to include other child in your family?
Third Child Name:
Date of Birth:
Gender:
Does your child have any allergies or medical concerns? If yes, please explain:
Members get 10% discount!
Please select:
Session | Program | Fees per week | Select | No. of Children | Fees | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Session 1: June 17 - June 23 | Program A | $1,000.00 | $0.00 | |||
2 | Session 2: June 24 - June 30 | Program B | $1,000.00 | $0.00 | |||
3 | Session 3: July 1 - July 7 | Program C | $1,000.00 | $0.00 | |||
4 | Session 4: July 8 - July 14 | Program D | $1,000.00 | $0.00 | |||
5 | Session 5: July 15 - July 21 | Program E | $1,000.00 | $0.00 | |||
6 | Session 6: July 22 - July 28 | Program F | $1,000.00 | $0.00 | |||
7 | Session 7: July 29 - Aug 4 | Program G | $1,000.00 | $0.00 | |||
8 | Session 8: Aug 5 - Aug 11 | Program H | $1,000.00 | $0.00 | |||
9 | Session 9: Aug 12 - Aug 18 | Program I | $1,000.00 | $0.00 | |||
10 | Total Fees | $0.00 |
Are you a member?
If yes, you get 10% discount:
Total Fees:
I give permission for my child/children to participate in selected activity.
Parent/Guardian Signature:
To configure an element, select it on the form.