2020/2021 Barnacles & Bees rollover waitlist
Email address *
Do you prefer *
Child Information
First Name *
Middle Name *
Last Name *
Date of Birth *
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Gender *
Parent / Guardian informations
First Name *
Last Name *
Child's relationship *
Address *
City *
Day Phone *
Please briefly state why you would like your child to attend this program. *
How did you hear about us *
What is the best way to contact you *
Are you planning on enrolling siblings? *
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We will contact you as soon as a spot open. Thank you!
A copy of your responses will be emailed to the address you provided.
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