Afternoon learning and play registration form
Thank you for your interest in our afternoon play sessions. Each class will take your child to explore endless possibilities. 
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Email *
Class/es you wish to register: *
Required
Home address *
Child's name *
DOB *
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DD
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Mom's name *
Mom's phone number *
Mom's email address: *
Dad's name: *
Dad's phone number *
Emergency contact, relationship and phone number: *
List all people allowed to pick up your child *
School the child attends to *
What are your child's interests? *
Allergies or medication, please be specific *
Is there anything else I need to know about your child? *
How did you hear about us? *
By this mean I allow Mariana Carazo and Erika Rivera to take pictures of my child and use them in social media. *
I agree to pay the monthly fee for each class registered, payable on the set dates for module classes or on the first day of each month for remediation and tutoring sessions. Months with a 5th class, will be charged additionally for monthly classes.  There's no make up sessions if class is missed. Form of payment:  Zelle: hello@developingmindsus.com *
Type your full name/ valid as signature *
Submit
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