Children's Registration

Name (parent)

This address will receive a confirmation email

Phone

Address

Child #1 Name

Child #1 Date of Birth

Any Allergies or concerns for our team to keep in mind?

Child #2 Name

Child #2 Date of Birth

Any Allergies or concerns for our team to keep in mind?

Please tell us who is authorized to pick your child up from class.

Description

Please fill out this form to help us plan for your children to attend Light Brigade classes (ages 4-12) or the nursery (ages 0-3).