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MakeSpace Cubs Program Enrollment Form 2023-2024
Assalaamu Alaikum! 

Please complete this form as enrollment for the Cubs Program for the 2023-2024 year.  Sessions will be 5 weeks long.  This program is for ages 3-5 years old.

Note: For multiple children, please fill out a separate form for each child. Tuition payments can be made using this link: 2023-2024 Tuition Form

Classes are weekly on Saturdays from 10:00-11:00 AM with a parent social time from 11:00-11:30 AM.

Session 1: Sept 30th - Oct 28th
Session 2: Nov 4th - Dec 16th  (*holiday Nov 11, Nov 25th)
Session 3: Jan 6th - Feb 10th (*holiday Jan 13th)
Session 4: Feb 24th - March 23rd (*holiday Feb. 19)
Session 5: April 20th - May 18th (*break for Ramadan/Eid from March 30-April 13)
Acceder a Google para guardar el progreso. Más información
Correo electrónico *
Child Name (First and Last) *
Child Date of Birth *
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Parent 1 Name  *
Parent 1 Email *
Parent 1 Phone number *
Parent 2 Name
Parent 2 Email
Parent 2 Phone number
Emergency Contact (Name, Relationship, Number) *
Home Address *
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