M.Y. Summer 2018
Registration Form
Email address *
Which session are you registering for? *
Parent/Guardian's Full Name *
Your answer
Address *
Your answer
Phone number *
Your answer
Email address *
Your answer
Child's Name *
Your answer
Age *
Your answer
Does the child have any allergies? *
Your answer
Does the child take any medications? *
Your answer
Emergency Contact Name and Number *
Your answer
Will before care/aftercare be needed *
Please note registration is not complete until the registration fee is paid along with one week payment. Please return to the payment page to complete the registration. Full payment for each session must be paid in full by week two of each session.
A copy of your responses will be emailed to the address you provided.
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