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NEW SPEECH KIDS AFTER SCHOOL CARE
ONLINE REGISTRATION FORM
NEW SPEECH KIDS
CLUB
REGISTERATION FORM
Need Help? Call or LiVe Chat @ 1 (855)553-0503
REGISTRATION TUTOR
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* COMPLETE THIS FORM FOR EACH CHILD
*ENTER THE CHILD'S ENTIRE NAME
* ENTER PARENT OR GUARDIAN EMAIL ADDRESS
* IN THE REGISTRATION INFORMATION BLOCK ENTER INFO BELOW:​
1. Start Date
2. Number of Children need care
3. Payment Schedule
(Weekly, Biweekly, or Monthly)
4. Medical concerns: Allergies on meds etc.
5. EXPECTED DROP-OFF TIME
6. EXPECTED PICK-UP TIME
7. YES or NO If your child or children may participate in fieldtrips, pics, & videos (specify any NO answers)
8. Note any additional INFO you would like to add.
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