( print out and bring with child for summer program )
Wee Blessings
Preschool & Academy
Summer Fun Registration 2010
Child’s Name:
_____________________________
Date
of Birth: _____________________________
Sex: Male/Female
Mother’s
Name: ____________________________
Father’s Name:
____________________________
Address: _________________________________
City:
________________________
Zip Code: _______________________
Home
Telephone Number: ______________________
Mom’s Cell Phone:
___________________________
Dad’s Cell Phone:
___________________________
Primary E-Mail address: _________________________
(X) Place an X by the date(s) that you are requesting. Registration will
be granted on a first come, first serve basis. Registration will be
held on Tuesday, May 4th at 9:15a.m and continue until all classes are
full.