1. 7 Addison Street
Larchmont, NY 10538
914-833-2880
Kindergarten Enrichment 2012
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___________________________________________________________________________
__________________________________________________________________________________________________
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2013-2014 Monthly Dates – MONDAY’S
October - 9/30, 10/7, 10/21, 10/28 - $120 or $136 with pizza lunch___________________________
November - 11/4, 11/18, 11/25 - $90 or $112 with pizza lunch _______________________________
December – 12/2, 12/9, 12/16 - $90 or $112 with pizza lunch________________________________
January – 1/6, 1/13, 1/27 - $90 or $112 with pizza lunch____________________________________