Group Registration Form

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Please fill out this form and select the group (and relevant information) you are registering your child for

Child's Full Name *

Parent / Guardian Full Name *

Child's Birthday *

YYYY

Parent Email *

Parent Phone *

Address *

Group Selection *

Social Stars (ages 2.5 - 3.5): Fridays 1215pm-100pm(November 21-January 23 no class November 28, December 22-January 2)Eight Week Rate $500

Social Stars (ages 4 - 5): Fridays 4:15pm - 5:00pm (November 21-January 23 no class December 22-January 2)). Eight Week Rate $500

Play Smart, Feel Strong (ages 6-8): Mondays 4:30pm-5:15pm (November 17- January 12 no class December 22-January 2)) Eight week rate $500

Play Smart, Feel Strong (ages 6-8): Wednesdays 4:30pm-5:15pm (November 19-January 21 no class November 26, December 22-January 2)) Eight week rate $500

Social Stars (ages 5-6) Mondays 5:30pm-6:15pm (November 17-January 12 no class December 22-January 2)) Eight week rate $500

Play Smart, Feel Strong Tuesdays 5:30pm-6:15pm (November 18-January 13 no class December 22-January 2)) Eight week rate $500

All Sports Class Ages 3- 4yo Mondays 345pm-430pm December 1-February 2(no class December 22-January 2) $500

All Sports Class Ages 5-8 yo Thursdays 500pm-545pm December 4 -February 2(no class December 22-January 2) $500

Social Stars Ages 3-4 yo Tuesdays 4:30pm-5:15pm (November 18- January 13 no class December 22-January 2)) Eight week rate $500

Required

Payment for all groups can be made by Zelle* or by Check** (registration not confirmed until payment received)

*information needed: email: hkorn01@hotmail.com; company: Kornerstone Kids LLC

**check made payable to Kornerstone Kids LLC

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