Parent's Name
*
First Name
Last Name
E-mail
*
ex: myname@example.com
Phone Number
*
-
Area Code
Phone Number
First Child's Name
*
First Name
Last Name
First Child's Age
First Child's Favorite Category
Dance
Theater
Music
Second Child's Name
First Name
Last Name
Second Child's Age
Second Child's Favorite Category
Option 1
Option 2
Option 3
Week(s) my child/children will be attending
*
May 29 - June 1
June 4 - June 8
June 11 - June 15
June 18 - June 22
June 25 - June 29
July 2 - July 6
July 9 - July 13
July 16 - July 20
July 23 - July 27
July 30 - Aug 3
All payments must be made to Jillian Englund. (Cash or Check Accepted)
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