Spring 2021 - Private Class Intake Form

Spring 2021 – Private Class Intake Form

Host Parent Name *

Phone *

Class Location *

Email *

Child Name & Age *

Total Number of Children Attending Classes *

Please include the below information for each child who will attend Private camp:

Child 1.

Parent Name

Phone

Email

Child's Name & Age

Child 2.

Parent Name

Phone

Email

Child's Name & Age

Child 3.

Parent Name

Phone

Email

Child's Name & Age

Child 4.

Parent Name

Phone

Email

Child's Name & Age

Child 5.

Parent Name

Phone

Email

Child's Name & Age

Child 6.

Parent Name

Phone

Email

Child's Name & Age

Child 7.

Parent Name

Phone

Email

Child's Name & Age

Child 8.

Parent Name

Phone

Email

Child's Name & Age

Child 9.

Parent Name

Phone

Email

Child's Name & Age

Child 10.

Parent Name

Phone

Email

Child's Name & Age

Signature *

File Upload (optional)

Click or drag a file to this area to upload.