Payments made on first day of session payable by cash or check.*
*Please note: For Whetstone and Lazelle Woods Recreation centers both registration and payment are made through the respective center.
Parent's Home Phone:
Parent's Cell Phone:
May we text you at your cell phone number?
YesNoOnly for emergencies
Student's Age Group:
5-67-89-1112 & up
Location desired for classes:
PickNazSunbury UMCSt.John's NewarkPrairie TownshipWhetstoneVineyardOther
Please provide us with emergency contact name and number:
Are there any health issues we should be aware of?
Please provide us with any other relevant information or questions you may have below. If multiple students are being enrolled, please provide the information for each additional student here.
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