St. Clare's Parenting Center Registration Form
September 29, 2014 -January 26, 2015
Parent’s Name:_______________________________________________________________
Address: _____________________________________________________________
Telephone:___________________________________________________________
Alternate Telephone: _________________________________________________
Email Address:_______________________________________________________
Child’s Name Birthday:
___________________________________ _______________
___________________________________ _______________
___________________________________ _______________
Amount Paid FALL SESSION_________________
SPRING SESSION_______________
Non Refundable Registration fee is $40 per family for Fall Session. $40 for Spring session due February 4, 2015. Cash only please.
Weekly sessions are $5 per child, $2 each additional child. Parties are $10 per child, $5 for each additional child.
X____________________________________________________I agree to the rules and policies of the St. Clare's Parenting Center and to the above fees.
September 29, 2014 -January 26, 2015
Parent’s Name:_______________________________________________________________
Address: _____________________________________________________________
Telephone:___________________________________________________________
Alternate Telephone: _________________________________________________
Email Address:_______________________________________________________
Child’s Name Birthday:
___________________________________ _______________
___________________________________ _______________
___________________________________ _______________
Amount Paid FALL SESSION_________________
SPRING SESSION_______________
Non Refundable Registration fee is $40 per family for Fall Session. $40 for Spring session due February 4, 2015. Cash only please.
Weekly sessions are $5 per child, $2 each additional child. Parties are $10 per child, $5 for each additional child.
X____________________________________________________I agree to the rules and policies of the St. Clare's Parenting Center and to the above fees.