Let’s Play to Learn Registration

Name

Phone Number

Email Address

What date(s) of Let's Play to Learn do you want to sign up for - September 27, October 27 and/or December 14?

Please provide name(s) and age(s) of child/ren attending workshop

How did you hear about this workshop?

Would you like to be added to our email list in order to receive info about future classes? Would you like to be added to our email list in order to receive info about future classes? Yes No

Do you need childcare? Do you need childcare? Yes No

Child's Name and Date of Birth

Child's Name and Date of Birth

Child's Name and Date of Birth

Child's Name and Date of Birth (If you have more than four children please call to set up childcare.)