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7 Addison Street
Larchmont, NY 10538
914-833-2880

Kindergarten Enrichment 2013-2014
Please use a separate registration form for each child.

Child’s Name: _____________________________________________________________________
Teacher’s Name :_________________________ Exit Door:________________________________
(Chatsworth only)

Date of Birth: _____________ Allergies: ________________________________________________
Email Address:____________________________________Contact Names_____________________
Cell: _______________________________ Home:________________________________________
Address___________________________________________________________________________
__________________________________________________________________________________________________

----------------------------------------------------------------------------------------------------------------------------------------------------

2013-2014 Monthly Dates – THURSDAY
October – 10/3, 10/10, 10/17, 10/24, 10/31 - $150 or $170 with pizza lunch____________________
November - 11/7, 11/14, 11/21 - $90 or $112 with pizza lunch ______________________________
December – 12/5, 12/12, 12/19 - $90 or $112 with pizza lunch_______________________________
January – 1/9, 1/16, 1/23, 1/30 - $120 or $136 with pizza lunch______________________________

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Kindergarten Enrichment Registration Form

  • 1. 7 Addison Street Larchmont, NY 10538 914-833-2880 Kindergarten Enrichment 2013-2014 Please use a separate registration form for each child. Child’s Name: _____________________________________________________________________ Teacher’s Name :_________________________ Exit Door:________________________________ (Chatsworth only) Date of Birth: _____________ Allergies: ________________________________________________ Email Address:____________________________________Contact Names_____________________ Cell: _______________________________ Home:________________________________________ Address___________________________________________________________________________ __________________________________________________________________________________________________ ---------------------------------------------------------------------------------------------------------------------------------------------------- 2013-2014 Monthly Dates – THURSDAY October – 10/3, 10/10, 10/17, 10/24, 10/31 - $150 or $170 with pizza lunch____________________ November - 11/7, 11/14, 11/21 - $90 or $112 with pizza lunch ______________________________ December – 12/5, 12/12, 12/19 - $90 or $112 with pizza lunch_______________________________ January – 1/9, 1/16, 1/23, 1/30 - $120 or $136 with pizza lunch______________________________