| Child: |
|
| Child's Age: |
|
| Child's Birth Date: |
|
|
|
| 2nd Child: |
|
| 2nd Child's Age: |
|
| 2nd Child's Birth Date: |
|
|
|
| 3rd Child: |
|
| 3rd Child's Age: |
|
| 3rd Child's Birth Date: |
|
|
|
| Parent(s) First and Last Name: |
|
| Adult Attending Class: |
|
| Address: |
|
| City, State, Zip Code: |
|
| Email address: |
|
| Phone Number: |
|
| Class Choice:(view schedule) |
|
| Class Choice:(view schedule) |
|
| Session Length:(view schedule) |
|
| Preview/Drop In Date Choice: |
|
|
|
|
*Space will be available on a first-come first-served basis. We will make every attempt to give you your first choice but please put down a second choice. Class placement will be confirmed via email. The 10-week 2010 Fall session will begin September 20th. Westfeild Classes are being held by Creative Kids please visit their website www.creativekidsnj.com for details. |
How did you hear about us/NOTES:
|
PARENT OR GUARDIAN, PLEASE READ THE FOLLOWING AND CHECK BELOW:
I agree to assume responsibility for my child or children and myself and/or caregiver when upon the premises operated by Preschool of Rock, Preschool of Rock and Michael Napolitano, Forum Theater, Creative Kids and will hold harmless Preschool of Rock, Preschool of Rock and Michael Napolitano, Forum Theater, Creative Kids and any of its employees and/or agents in the event of any personal injury, property damage or loss, indemnifying said parties of any loss that I might incur as a result. |
|