Contact name *

First Name

Last Name

Child's name *

First Name

Last Name

Child's DOB *

MM

DD

YYYY

Desired enrichment subjects

Please check all that may apply.

Music and Movement (Tuesdays 8:30 - 12:00)

Science (Wednesdays 8:30 - 12:00)

Art (Thursdays 8:30 - 12:00)