Daddy & Me Registration - ChabadNW6.com

Daddy & Me Registration Form
We look forward to welcoming your child/ren to our new Daddy & Me programme!

The cost of registering your child is £65 per semester / £195 for the year.
Child's Name*

First Name Last Name
Please choose the appropriate age group for your child*

2 - 3 years old 4 - 5 years old
Child's Name

First Name Last Name
Please choose the appropriate age group for your child

2 - 3 years old 4 - 5 years old
Child's Name

First Name Last Name
Please choose the appropriate age group for your child

2 - 3 years old 4 - 5 years old

Address*

Additional notable Information
Parents Information
Father's Name*

First Name Last Name
Mother's Name*

First Name Last Name
Phone Number:*
Email Address:*
Please choose option of payment:*

1 Semester - £65 2 Semesters - £130 3 Semesters - £195
Payment

Payment*

Credit Card

/ Expiration Month Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

This page uses TLS encryption to keep your data secure.

Daddy & Me Registration Form