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
Student 3:First Name Last Name
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