2021-2022 SEG Registration
This form is for clients who attended during the 2020-2021 School Year or Summer 2021 session only. Clients returning after a break of 6 months or more should contact the office for a modified intake process.
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Your Name (First & Last Name)
Email Address for Contact Purposes
Email Address for Invoicing
Your Child's Name (First & Last Name)
WILL return for the 2021-2022 session
WILL NOT return for the 2021-2022 session
Your Child's Current Group or Last Group Attended
Please choose the most recent group your child attended, either Summer 2020 or Winter/Spring 2020. If you child has not attended in 2020, please choose OTHER
Monday 4:45pm - Fast Friends with Sara, Jessica & Emma
Monday 6pm - Empower 3 with Jessica
Tuesday 5pm - Mighty Mates with Sara & Emma
Tuesday 5pm - EmPower 1 with Jessica
Tuesday 5:30pm - Cool Crew with Becky
Tuesday 6pm - Empower 2 with Jessica
Wednesday 4pm - Busy Buddies with Sara & Emma
Wednesday 5:15pm - Fast Friends with Sara, Jessica & Emma
Wednesday 6:30pm - Teen Talk 2 with Michelle
Thursday 6pm - EmPower for All with Bonnie
New for Summer 2021 - Mighty Mates
New for Summer 2021 - Crew Hour
New for Summer 2021 - Buddies Hour
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Keriann Kimball.