Winter/Spring 2013 Registration Form

After School Activities Registration Form
Please complete the form below to register for Winter/Spring classes. The Winter/Spring 2013 Session dates are Tuesday, January 22 -Friday, May 17.

· Make checks payable to Wayne Thomas PTA

· Registration form, permission slip (see page 8), and payment due by December 21, 2012

· Registration form and permission slip are also available on the PTA Website (www.waynethomaspta.com) and 
our blog (wtafterschoolactivities.blogspot.com).

Family Name _______________ Phone _______________ Email _________________

Check here if you qualify for Military Discount through some vendors _______

Class	Day	Price	First Student Name: ________ Grade: ________ Teacher: ______	Second Student Name: ________ Grade: ________ Teacher: ____	Third Student Name: __________ Grade: _______ Teacher: _______
After School Games	M T W Th F	$62 $62 $72 $72 $76
Mad Science 1st-5th	M	$166
Beading with Ros	M	$234
Mindful Practices Yoga 1st – 5th	T	$182
Young Rembrandts 1st – 5th	W	$165
Girls on the Run 3rd – 5th	T/Th	$195
Acrofabulous	Th	$180
Skyline Studios	F	$192
Kindergarten Mad Science	M	$153
Kindergarten Mindful Practices Yoga	T	$169
Kindergarten Young Rembrandts	W	$150
TOTALS:			# of Checks _____ Total:  $______	# of Checks _____ Total:  $______	# of Checks _____ Total:  $_______