Contact: aimee German (718) 623-8560

Click Here for print and mail Registration Form

Click Here for print and mail Payment Form

ONLINE ENROLLMENT FORM

Please fill out form and online payment options will appear after submission.

LOCATION & SESSION DATES:

Please type Class Location or "Circus Camp" 

Parent(s) Info  
1st Parent Name  2nd Parent Name 
Relation to Student  Relation to Student 
Home Phone  Home Phone 
Work Phone  Work Phone 
Cell Phone/Pager  Cell Phone/Pager 
Family E-mail Address   
Snail Mail Address  City 
State  Zip 
Emergency Contact   
Phone  Relation 
   
Student Info  
Student's  Name  Date of Birth 
 Age on July 31  Gender 
Grade  School 
 

Special Info

  
Do you have any special needs or requests for your child?   
Any additional information you would like us to know about your child? 
How did you hear about us? 

Please submit below and Payment Details will follow!