LittleLeaf School llc.

*Parent(s) Name:
*Child's Name:
*Child's age:
*Parent(s) Email Address:
*Parent(s) Phone #'s (please include home and cell numbers for each parent)
*Home address:
*Emergency Contacts: Please list 3 emergency contacts; Name, Relation and Phone #'s
Please list any allergies or food restrictions/ diet choices (vegan, diabetic, gluten-free, etc).
which sessions would you like to register for?
Week #1 - June 28th - July 2nd
Week #2 - July 5th - July 9th
Week #3 - August 16th - August 20th
Week #4 - August 23rd - August 27th