Parent's Name: Other Parties cleared to pick up child: Child's Name: Child's Age: Address: Phone Number: E-Mail Address: Please Select a Session to sign up for: Tuesday Session ($77.90/month) or before May 10 $70.11 Thursday Session ($77.90/month) or before May 10 $70.11 Both Sessions ($150.80/month) or before May 10 $135.72 Special Needs or Allergies: Payment is due first class of each month.