3D Kids Academy Registration Form: After School Program—Fall 2019
Registration is now open. Sign up early to secure your spot!o
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Email *
Choose your program *
Child's name *
Parent's full name *
Parent's email address *
Home Address *
Parent's contact phone number(s) during class hours *
Form of payment *
Required
My child is a *
My child is currently in grade   __________. *
My child's date of birth is *
(month/date/year)
My child is a student at:
(if different from host school)
Child's previous sewing experience *
Please describe any medical conditions, allergies or other issues that may affect my child *
Who shall we thank for referring you to 3DKids Academy? *
Please name the person, publication, organization or web site.
I hereby give permission to use my child's image in promotional materials for 3DKids Academy *
Emergency contact information, should I prove unreachable *
I give the following other people permission to pick up my child *
please list all and include phone numbers
A copy of your responses will be emailed to the address you provided.
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