Parent/Guardian #1 Full Name * First Name Last Name Contact Number * (###) ### #### Relationship to Child * Parent/Guardian #2 Full Name First Name Last Name Contact Number (###) ### #### Relationship to Child Email * Emergency Name & Phone Number (other than parents) * Names of people authorized to pick up your child in addition to parents * Child Name * First Name Last Name Date of Birth * MM DD YYYY How old is your child? * Which day(s) would you like your child(ren) to attend? * 10% off when sign up for 2 or more days 15% off when sign up all 5 days Full Week Dec 22 Dec 23 Dec 29 Dec 30 Jan 2 Dec 22 (Half day) Day 23 (Half day) Dec 29 (Half day) Dec 30 (Half day) Jan 2 (Half day) Does your child have any allergies that we should be aware of? * How did you hear about us? * Instagram Whatsapp/ Facebook groups XHS Referral/Others Additional comments/questions Thank you for your registration.! We will send an email confirmation within 48 hours. Sign Up Form
