Family U

Family U Registration - Winter 2012
* = required information


Head of Household:    *Last Name      
                                  
 *First Name  

*Home Phone

E-mail Address

*Street Address

*City      Zip 


Please complete this section for each person registering for a class:
(If you are registering more than three people, please submit another form.)

Student 1: 
First Name
  Last Name

Age (child)    Grade (child)

Class Title


Student 2:
First Name
   Last Name

Age (child)   Grade (child)

Class Title


Student 3:
First Name
  Last Name

Age (child)   Grade (child)

Class Title


Parents, if you are enrolling children:

1. Where can you be contacted if you are not attending a Family U class?

Phone number and/or location

2. My child  has the following food allergies: 
                                            

Parents, if you plan to leave children in the nursery:

     Number of Children:   Ages of Children


Enter the numbers as they
are shown in the image above