Enrollment Form

If you will be enrolling more than one child please submit a separate form for each child.

Child's First Name *
Child's Last Name *
Address *
City *
Zip Code *
Birthday *
Age *
School *
Grade *
Mother's Name
Father's Name
Siblings (M/F-age) (ex: M-14,F-9)
Referred by
Best way to be contacted
Phone number (mom) *
Phone number (daughter)
What month would you like to bring snacks *
Do you give permission to have your daughter photographed or videotaped *
Questions or Comments