CLUBS REGISTRATION FORM for HANC 609, Spring 2015

HANC 609, Spring 2015

Please mail/drop off this form with your check made out to HANC PTA to:  Shani Herschberg

                                                                                                                                                230 Bedell Terrace

                                                                                                                                                West Hempstead, NY 11552

Last Name:                                                                                                                                                                              

Please list up to 3 phone numbers of yours you'd like us to have:                                                                                         

                                                                                                                                                                                                

Parent’s e-mail address:                                                                                                                                                          

Emergency Contact: (someone other than child’s parent):

Name:                                                                                                                                            Phone #:                          

Child #1

First Name:                                                                                          Grade:                                                      Teacher/room #:                                   

Clubs child is registering for:  (please list #s only):                                                      Medical Alerts:                                    

                 

Child #2

First Name:                                                                                          Grade:                                                      Teacher/room #:                                   

Clubs child is registering for:  (please list #s only):                                                      Medical Alerts:                                                     

Mondays                                   

[1]  Zumba, girls grades K-2, $125                                                     

[2]  color guard, girls, 3rd grade, $125                                                                                         

Wednesdays                                                                                                            Thursdays

[3]  sports for boys, grades 3-6, $115                                                      [5]  art, boys and girls grades K-2, $235

[4]  Zumba, girls grades 3-6, $100                                                          [6]  knitting and crocheting, girls grades 3-6, $135

                                                                                                                 [7]  Project Fit, boys and girls, K-2, $160

Please e-mail any questions or requests to be parent volunteer to shani.herschberg@gmail.com.

10% off additional and cheaper club(s) must be in the same building, one paid club at 609 gets additional club(s) AT 609 10% off, same for ECC.

Unless you hear from a PTA representative, please consider your child registered when you submit your form and check.  When a club has met its minimum to run, you will receive an e-mail.  If we do not meet the minimum number of children needed to run the club, you will receive an e-mail indicating such and given an opportunity to register for a different, available club.