Carlisle Elementary - CraniaLogix Spring 2019 - 3rd/4th/5th grades
Registration information for Spring 2019 will be coming soon! REGISTRATION ON THIS FORM IS NOT AVAILABLE AT THIS TIME AND WILL NOT BE RECORDED. Please look for information to come home from your child's school later in the fall or check back on our website for more detailed information about the spring semester.
Student's First Name *
Your answer
Student's Last Name *
Your answer
Grade Level *
Teacher's Last Name *
Your answer
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Phone number to reach parent during CraniaLogix class *
Your answer
E-mail *
Your answer
Please share any medical or educational concerns we should know about. If your child has an IEP or is on a 504 plan, please provide that information to us before classes begin. *
Your answer
How student is getting home *
If your child is being picked up by an adult, please list those authorized to pick up. *
Your answer
A PTA member is needed to volunteer for after school programs at Barksdale. CraniaLogix is happy to provide a 50% discount to a parent who is willing to commit to attending and helping as needed at all classes for the session. If you are interested, please leave your name and email address in the space provided, and we will contact you with more details.
Your answer
I understand that I will receive an email upon registration either confirming space in the class or that my child is on a wait list. Space is limited to the first 20 registrants. Payment information and other class information will also be provided in that confirmation email. *
I have read and agree to the CraniaLogix Agreement and Release found here: https://tinyurl.com/y7w28bhz *
My child will receive a FREE CraniaLogix t-shirt to wear on class days! *
Submit
Never submit passwords through Google Forms.
This form was created inside of CraniaLogix. Report Abuse - Terms of Service - Additional Terms