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? What date(s) of Let's Play to Learn do you want to sign up for? Wednesday, January 17 (ages 1-2) Monday, January 29 (ages 3-4) Wednesday, February 28 (ages 3-4) Thursday, February 29 (ages 1-2) Wednesday, April 10 (ages1-2) Monday, April 22 (ages 3-4) Friday, May 10 (ages 1-2) Wednesday, May 22 (ages 3-4)

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

Please provide the name(s) and age(s) of child(ren) needing childcare