Last Name:         First Name:        Middle Name:    

Home Address: Street Name and Number

City:                Province:      Postal Code:

Home Phone: Cell Number:

Last Name:         First Name:        Middle Name:    

Home Address: Street Name and Number

City: Province: Postal Code:

Home Phone: Cell Number:

Class Grade:     Grade K Grade 1 Grade 2 Grade 3

Day: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Time: 10-11 11-12 1-2 2-3 3-4 4-5 5-6 6-7 7-8