2021 Spring Kids Club – Gardening (K,1,2)

Mondays from 3:00-4:00 pm on Zoom.

Child's Name*
First Last
Child's Classroom Teacher or Class #*
Child's Cohort*
Parent/Guardian Name*
First Last
Parent/Guardian Email*
Parent/Guardian Phone*
Parent/Guardian #2 Name
First Last
Please only fill out if the second parent/guardian needs to be informed about Kid's Club updates.
Parent/Guardian #2 Email
Parent/Guardian #2 Phone
Address
Street Address Address Line 2 City State ZIP Code

Please fill in your address if you allow Eman to deliver materials to your home.
Is there anything we should know about your child?
Winter 2021 - Kids Club - Gardening (K,1,2)*
- With Materials Fee ($265)
You are being charged $65 for supplies for this class. Your materials will either be personally delivered to your home or will be available for pick up at PS 321! You will not receive all of your materials at the beginning of the cycle, but will have several drop off/pick up times throughout your 10 weeks together.
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name