Laughing Llama Registration

1
Parent/Guardian Name
First Name
Last Name
2
Student Name* This field is required.
First Name
Last Name
3
Date of birth
Date
Year
Month
Day
4
Date of Birth #2
Date
Year
Month
Day
5
Student Name #2
First Name
Last Name
6
Email* This field is required.
example@example.com
7
Mobile Number
Phone Number
8
Does your child/children have any special considerations (medical issues, behavioural considerations)?
YESNO
9
If so, please describe below
10
Type a question
Homeschool Theatre Club -Thursday
11
I give permission for Laughing Llama to respectfully use my child's photo in online marketing and promotional material* This field is required.
YESNO
12
Signature
Clear
13
Image FieldThank you, we hope you have a whole llama fun in our classes!
Should be Empty: