Child's Name *

First Name

Last Name

Child's birthdate *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Caregiver Name

First Name

Last Name

Parent/Caregiver Phone

(###)

###

####

Please select your preferred days *

Please note, you must select 2 or 3 sessions per week. April 3rd - April 27th Excluding April 10th (Easter)

Mondays, Tuesdays, Thursdays 1-3pm ($1870)

Tuesdays & Thursdays 1-3pm ($1360)

Mondays & Tuesdays 1-3pm ($1190)

Mondays & Thursdays 1-3pm ($1190)