363 Baldoon Road, Unit 200

Chatham, ON, N7L 0C1

Phone Number

Strong families, bright futures

kal yoga title only.png — Registration Form

Please complete the following fields to register your child for the kaleidoscope kids: YOGA program, running October 7 to November 25, 2017. One registration form is required per child.

Sections marked with an asterisk (*) are required.

Your Name

First Name

Last Name

Your Child's Name

First Name

Last Name

Your Child's Birthdate

YYYY

Your Email Address

Your Phone Number

(###)

###

####

About Your Child

Feel free to use this space to describe your child's needs or why you are interested in this group.

Method of Payment (payment in full required on or before October 7, 2017)

How did you hear about this group?

Facebook

Flyer

Friend

kaleidoscope child and family care website

Other