Head of Household Phone - indicate cell (C) or home (H) *
Your answer
Spouse Phone - indicate cell (C) or home (H)
Your answer
Email Address for class communication (if other than the one used to register)
Your answer
Street Address *
Your answer
City, State & Zip *
Your answer
How many individuals will be attending the class? *
Your answer
Children/s Name, Date of Birth, Grade (This information is necessary if your children will at some point be participating in any children's activities and/or nursery.)