PARENT-CHILD ACORN ENROLLMENT FORM
Parent/Guardian Name(s)
*
Primary Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Child's Name
*
First Name
Last Name
Child's Birth Date or Due Date
*
-
Month
-
Day
Year
Date
Gender
May we share your contact information with other families in the class?
*
Yes
No
How did you hear about PCWS?
Enrollment Fee
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Winter Session Parent-Child Acorn Enrollment Fee
$
150.00
Total
$
0.00
Credit Card
Submit
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