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You and Me 2023 Fall Registration
Please fill out the below form to enroll in the Fall 2023 You and Me Program. Please note, classes need a minimum of 4 children enrolled to run.
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Email
*
Your email
Child's First Name
*
Your answer
Child's Preferred First Name
*
Your answer
Child's Last Name
*
Your answer
You and Me Class Fall 2023
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Tuesday's 9:00am - 10:15am
Friday's 9:00am - 10:15am
Child's Birthday
*
MM
/
DD
/
YYYY
Child's Age as of 9/1/2023
*
Your answer
Gender
*
Male
Female
Child's Home Street Address
*
Your answer
Child's Home City
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Your answer
Child's Home Zip Code
*
Your answer
Name of Parent
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Your answer
Name of Parent Attending Class (may list multiple)
*
Your answer
Parent Phone Number
*
Your answer
Parent Email Address
*
Your answer
Parent Phone Number
*
Your answer
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