Parent/Child Registration Child's Name * First Name Last Name Child's Date of birth MM DD YYYY Parent/Guardian Name First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email Allergies & Developmental concerns Please share with us if your child has any allergies or if you have any developmental concerns. Social Media & Website We like to share the fun we have in class on our social media and website. Do you give us permission to post photos of your child? Yes No Emergency Contact (###) ### #### Class choice * The "Baby's First Year" (Birth to 12 months) Class is $190 per 3 month session The 10-20 Month Class is $210 per 3 month session For the 20+ Month Class, it's $227 for one weekly class per 3 month session, or $399 for two weekly classes. 10 - 20 Month Class Wednesdays 20 + Month Class Tuesdays 20+ Month Class Wednesdays 20+ Month Class Thursdays 0-12 Months Thursdays Open Play Tuesdays Date MM DD YYYY Sign your name: Thank you for choosing Kids Club House!
