Little Leapers - 6 Week Session Form

Parent's Name *

Student's Name *

Student's Birthdate *

Email *

Phone *

Any allergies or medical conditions we should know about? *

Which class day/time works best with your schedule? *

Wednesday 4:30-5:00 PM

Saturday 11:00-11:30 AM

Payment *

Ages 1-2 - 6 Week Mini Session

$129

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