Aldridge Elementary - CraniaLogix Spring 2018 - 3rd/4th/5th grades
Please fill in all of the following information to be registered for the spring 2018 session.

Session Dates: Thursdays, Jan. 25 - Apr. 5 (no class Mar. 15)

Space is on a first come, first served basis and is limited to the first 20 to sign up.

At least half of tuition is due in order to reserve your child's space. The balance is due the first day of class unless a payment plan has been arranged. Payments can be made by check or PayPal. **Payment options will be included in the confirmation email you receive upon submission of this form.

Student's First Name *
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Student's Last Name *
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Grade Level *
Teacher's Last Name *
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Parent's First Name *
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Parent's Last Name *
Your answer
Home Phone *
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Cell Phone *
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Phone number to reach parent during CraniaLogix class *
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E-mail *
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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. *
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How student is getting home *
If your child is being picked up by an adult, please list those authorized to pick up. *
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A PTA member is needed to volunteer for after school programs at Aldridge. 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.
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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! *
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