EmailMeForm
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Child #1
Is your child currently enrolled in a Kid's Clubhouse Childcare Program?
If so, what program is your child enrolled in?
Please Select one of the following options
No, my child is a Drop-In
My child is enrolled in the Before School Only OR After School Only Program
My Child is enrolled in the Before AND After School Program
My child is enrolled in the All Inclusive Program
Child #1 - Drop-In
Select the drop-in days you would like to register for.
*
September 26th
Child #1 - Before OR After Camper
Select the drop-in days you would like to register for.
*
September 26th
Child #1 - Before AND After Camper
Select the drop-in days you would like to register for.
*
September 26th
Child #1 - All Inclusive Camper
Select the drop-in days you would like to register for.
*
September 26th
1st Child's Name
*
First
Last
Female Or Male
*
Female
Male
Birth Date
*
MM
/
DD
/
YYYY
Special remarks, allergies, etc.
Do you want to register a 2nd Child?
*
Yes
No
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Total
$0.00
