EmailMeForm
Rascalz Registration Form
Child 1 Name
*
Parent's Name
*
First
Last
Child 1 DOB
*
MM
/
DD
/
YYYY
Child 2 Name
Child 2 DOB
MM
/
DD
/
YYYY
Child 3 Name
Child 3 DOB
MM
/
DD
/
YYYY
Email
*
Cell Number
*
###
-
###
-
####
Alternate Phone Number
###
-
###
-
####
Child 1 Class Day
*
Please select
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Child 1 Class Location
*
Alga Norte - Carlsbad
Aviara Park - Carlsbad
Encinitas Community Park - Encinitas
Leo Mullen - Encinitas
La Colonia Park - Solana Beach
Carmel Grove Park - Carmel Valley
Carmel Valley Rec Center - Carmel Valley
Ocean Air Rec Center - Carmel Valley
La Jolla Rec Center - La Jolla
Kate Sessiona Park - North PB/La Jolla
NTC Park - Point Loma
Tidelands Park - Coronado
Pioneer Park - Mission Hills
Rancho Ponderosa - Encinitas
Pacific Highlands Ranch
Child 1 Class Time
*
Child 1 Class Type
*
Please select
Regular
Mommy and me (Parent participation)
Vet
Advanced
Which Session
*
Which Session
Late Spring Session starting in May
Early Spring Session starting in March
Child 2 Class Day
Please select
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Child 2 Class Location
Please select
Alga Norte - Carlsbad
Aviara Park - Carlsbad
Encinitas Community Park - Encinitas
Leo Mullen - Encinitas
La Colonia Park - Solana Beach
Carmel Grove Park - Carmel Valley
Carmel Valley Rec Center - Carmel Valley
Ocean Air Rec Center - Carmel Valley
La Jolla Rec Center - La Jolla
Kate Sessiona Park - North PB/La Jolla
NTC Park - Point Loma
Tidelands Park - Coronado
Pioneer Park - Mission Hills
Rancho Ponderosa - Encinitas
Pacific Highlands Ranch
Child 2 Class Time
Child 2 Class Type
Please select
Regular
Mommy and me (Parent participation)
Vet
Advanced
Which Session
Which Session
Late Spring Session starting in May
Early Spring Session starting in March
Anything you would like us to know and or any special needs your child has.
How did you hear about us? This really helps us, thank you!
*
New or Returning Family:
New or Returning Family:
New
Returning
Discounts?
Discount you're eligible for:
Sibling
Military