Fall Registration Form
2009-2010

This form may be printed 

Registration fee is $25.00 for the first Child and $20.00 for each additional child.    

       *No Fundraisers and No Recital Fee  No Contracts*

          Registration Fee is Non-refundable.

Name__________________________________________________________

Address________________________________________________________

             ________________________________________________________

Date of Birth   ____________________________________________________

Parents Name    __________________________________________________

                         ___ _______________________________________________

Phone number____________________________________________________

Work Phone Number______________________________________________

Emergency Number________________________________________________

Email  __________________________________________________________

Cell # __________________________________________________________

Allergies ________________________________________________________

Class Choice 1___________________________________________________

Class Choice 2__________________________________________________

                      Lesson fees are non-refundable after payment session begins

                                            Creation Academy Preschool 
                            
Director: Justine Garozzo-Britton
                                              856-467-0988