Child's Information
Child's Name *
Child's Name
Address
Address
Address
Birthdate
Birthdate
Gender *
Program *
Parent/Guardian Information
Parent/Guardian #1
Parent/Guardian #1
Address (if different than above)
Address (if different than above)
Cell Phone *
Cell Phone
Parent/Guardian #2 *
Parent/Guardian #2
Address (if different than above)
Address (if different than above)
Cell Phone
Cell Phone
Billing
Billing Address
Billing Address

By acknowledging and submitting this application, i am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.