Returning Students Fall 2018Before filling out the registration form please check the appropriate box below: *Returning Student (Any class)Child's Name (First and Last) *What is your child's grade level? *Parent/Guardian Name(s) (First and Last) *What is the name of your child's homeroom teacher? Or, room number? Parent/Guardian Email *Address Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone Any additional siblings that will be taking class? Please include their first and last name(s), age(s), birthdate(s), and gender(s). You are registering for the Fall Session 2018 at Lafayette Elementary, please choose one of the following options * ATTN: AcroDance reg. is now closed. It's full. Email Tine if you have any questions. + AcroDance (2nd-5th Grades/returning students only... any class) is a multi-cultural gymnastics and dance, inspired by folkloric dances of Haiti, Brazil, Philippines and more. The class also incorporates creative movement, isolations, live drumming and self-expression through students own choreography. + Rhythm + MVMNT (K-1st Grade) focuses on creative movement using rhythmic exploration, multicultural storytelling and gymnastics. Rhythm & MVMNT - Tuesdays, 2-3 PM / $195AcroDance WAITLIST ONLYHow will you be paying for class registration? Please bring your method of payment on the first day of class. Contact Tine for late registration. The fee will be prorated.CashCheck payable to: Christine FerrerPAYPAL (Friends & Family) to: c.joy.ferrer@gmail.comPlease read carefully, before checking the box below: I, parent guardian, authorize a media release with the understanding that any photos, articles, student work, video footage, etc. from my son/daughter may be used for promotional materials. I understand that Eyes Opened (EO) staff and volunteers will take the utmost care of my child, and in the unforeseen event of lost or damaged property, or unavoidable injury to my child, I will not hold EO (Christine Joy Ferrer AKA Tine) or its staff/volunteers liable. I understand the goals of EO and gladly support my child, and the EO facilitators, in achieving these goals.I consentI decline VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
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