Mighty Cubs Individual Registration Form

Individual Registration Form
(For Group registration click here)

General information

If you are looking for a class for your pre-schooler please fill out the below information.

There is no charge to register your child. After you have filled out the form our staff will do our best to help you a class the fits your time preferences.

Child's First Name:		Child's Last Name:
Child's Gender:	Boy Girl	Date of Birth:	(example: 05-31-2005)
Parent/Guardian's First Name:		Parent/Guardian Last Name:
Email:			Cell Phone:
Parent/Guardian's DOB:		(The parent's date of birth is used to add you into the database which is required for a a child to be added).
Home Phone :		Work Phone:

Address:

City:

Zip:

Day/Time Preferences:	Day:		Day:
	and Time:		and Time:

How did you hear about us?
If you heard from a friend please give them credit:

Comments or questions:

Mighty Cubs holds classes at

at the