Kindergarten Program Registration Form for Fridays

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Kindergarten Program Registration Form for Fridays

  1. 1. 7 Addison Street Larchmont, NY 10538 914-833-2880 Kindergarten Enrichment 2013-2014 Please use a separate registration form for each child. Child’s Name: _____________________________________________________________________ Teacher’s Name :_________________________ Exit Door:________________________________ (Chatsworth only) Date of Birth: _____________ Allergies: ________________________________________________ Email Address:____________________________________Contact Names_____________________ Cell: _______________________________ Home:________________________________________ Address___________________________________________________________________________ __________________________________________________________________________________________________ ---------------------------------------------------------------------------------------------------------------------------------------------------- 2013-2014 Monthly Dates – FRIDAY October – 10/4, 10/11, 10/18, 10/25, 11/1 - $150 or $170 with pizza lunch____________________ November - 11/8, 11/15, 11/22 - $90 or $112 with pizza lunch ______________________________ December – 12/6, 12/13, 12/20 - $90 or $112 with pizza lunch_______________________________ January – 1/10, 1/17, 1/24, 1/31 - $120 or $136 with pizza lunch_____________________________ February - 2/7, 2/14, 2/28 - $90 or $112 with pizza lunch ___________________________________ March - 3/7, 3/14, 3/21, 3/28 - $120 or $136 with pizza lunch________________________________ April - 4/4, 4/11 4/25, 5/2 - $120 or $136 with pizza lunch__________________________________ May – 5/9, 5/16, 5/23, 5/30 - $120 or $136 with pizza lunch_________________________________ June – 6/6, 6/13, 6/20 - $90 or $112 with pizza lunch______________________________________

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