Registration

Child's Information

Child's Name
*First: *Last:

*Age: *Grade:18-35 MonthsAge 3Pre-KKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th

*Child's Address

Please let us know if you child has any physical limitations, allergies or special needs

Parent/Guardian Information

*Parent/Guardian First Name *Parent/Guardian Last Name
*Relationship MotherFatherLegal Guardian
*Cell Email
*Employer

Optional Second Parent/Guardian Information:

Parent/Guardian 2 First Name Parent/Guardian 2 Last Name
Relationship MotherFatherLegal Guardian
Cell Email
Employer

Emergency Contact

*Contact First Name *Contact Last Name
*Contact Cell

Class Choice

*Please indicate class choice(s)

(example: Monday Mini-Force 3-4pm) Please be sure to sign up for the appropriate age group