Printed from JewishFLL.com
For Infants, Toddlers and Moms.

Mommy & Me Registration

Mommy & Me Registration

Mommy & Me Registration Form

First Name

 

E-Mail

Last Name

 

Phone

Child's Name   Child's DOB

 

       
I would like to register for:

Package discount 5 classes = $50

  Drop in - ($15) per class
         
Payment
Pls charge my card below.I will pay at the door.    
CC Type   Card Number
Charge Amount   Exp Date
CVV

Secure This page uses 128 bit SSL encryption to keep your data secure.