Application For Enrollment in Summer Session
Summer Sessions:Tuition is $170 Per Two Week Session and $85 per week thereafter. The Summer Registration Fee is $30.
Child's First, Middle, and Last Name *
Best Email to Reach You *
Child's Birth-date : m/d/y *
*
Father's First Name *
Father's Last Name *
Father's Phone Number *
Father's Email Address *
Mother's First Name *
Mother's Last Name *
Mother's Phone Number *
Mother's Email Address *
Alternate person to call in Emergency *
Name of Persons authorized to take child from the Facility . Please leave name and phone number *
Next
Never submit passwords through Google Forms.
This form was created inside of Westminster Presbyterian Church. Report Abuse