Single Child Winter 1 - 7weeks

Select Returning or New student? New Returning

Child's Name

Select Birth Month 1 2 3 4 5 6 7 8 9 10 11 12

Select Birth Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Select Birth Year 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995

Parent First Name

Parent Last Name

Home Phone

Work/Cell Phone

Emergency Contact (for drop-off)

Emergency Phone

Allergies (Food & Other)

Select Age Group 18mo - 2-1/2yrs 2-1/2 - 3-1/2yrs 3-1/2 - 5yrs K - 1st grade 2 - 5th grade

Select Art, Cooking, Art & Cooking SAVE 50% Art Cooking Art & Cooking SAVE 50% on 2nd class (+$122.50)

1st Choice (Art &/or Cooking | Day | Time)

2nd Choice (Art or Cooking | Day | Time)

In the event of a medical emergency the staff of Creative Castle will:
1. Call 911 emergency services.
2. Attempt to contact a parent, guardian or emergency contact person listed.
Select Emergency Approval Permission Granted Permission NOT Granted

Permission is granted for my child / children to be included in
pictures or video of promotions connected with Creative Castle.
Select Picture Approval Permission Granted Permission NOT Granted