Registration

There are no classes at this time. Thank you for your support over the last three years!
-Much love, from Ms. Olivia

Select Class:

Preferred Day/Time:	(e.g. Tuesdays 09:30)

Parent's First Name:
Parent's Last Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Email Address:
Home Phone Number:	- -
Work Phone Number:	- -
Cell Phone Number:	- -

Alt. Contact Person:
Alt. Contact Phone:	- -

Child's First Name:
Child's Last Name:
Child's Current Age:	months years
Child's Birthdate:	(MM/DD/YYYY)

List any allergies or medical issues of which the teacher should be aware:


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