First Child's Information

* First Name

* Last Name

* Birth Date

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* Hour 1 Class

Infant - 1 Yr Old Nursery

2 Yr Old Nursery

Little Explorers (3 Yr Old Preschool)

Discovery Kids (Prek-K)

Wild About Insects (1st-3rd)

Heading West Pioneers (1st-3rd)

Great American Artists (1st-4th)

Magic Treehouse Books (2nd - 4th)

Engineering (3rd - 5th)

Crocheting (4th - 12th)

Model Cars (4th - 12th)

Knights & Castles (3rd - 5th)

Broadcast News (6th - 12th)

CSI Expert (5th - 8th)

High School Assistant (9th - 12th)

* Hour 2 Class

Second Child's Information

First Name

Last Name

Birth Date

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Hour 1 Class

Hour 2 Class

Third Child's Information

First Name

Last Name

Birth Date

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Hour 1 Class

Hour 2 Class

Fourth Child's Information

First Name

Last Name

Birth Date

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Hour 1 Class

Hour 2 Class

Fifth Child's Information

First Name

Last Name

Birth Date

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Hour 1 Class

Hour 2 Class

Sixth Child's Information

First Name

Last Name

Birth Date

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Hour 1 Class

Hour 2 Class

Parent's Information

* Father's First Name

* Mother's First Name

* Last Name

* Address 1

* City

* State

* Zip

* Phone

Cell Phone

* Email Address

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