Enrollment Parent Guardian Information First Name Last Name Address City State/Country Home Phone Cell Phone Work Phone Your Email Children Information Name Birthday Grade/Fall Address Child 2 Name Birthday Grade/Fall Address Child 3 Name Birthday Grade/Fall Address Dates Attending (Minimum 2 Week Enrollment Per Child Required) Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Additional Comments and/or Information