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Happy Hands After School Club Registration Form

flyer

Please complete the form below to SignUp

Required fields marked with an asterisk *

Student Information

Student's First Name*

Answer required for "Student's First Name"

Student's Last Name

Answer required for "Student's Last Name"

Student's Grade*

Answer required for "Student's Grade"

Parent Information

Full Name*

Answer required for "Full Name"

Phone Number*

xxx-xxx-xxxx

Number Required

Pickup Person Full Name*

Answer required for "Pickup Person Full Name"

Relationship to the student being pickedup*

Answer required for "Relationship to the student being pickedup"

Fee*

8 weeks program

Answer required for "Fee"

$319.00

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"