Itsy Bitsy Registration Form

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Itsy Bitsy Playgroup (Birth-15 months)

FRIDAYS, December 1-February 29 from 9:15-10:00 am

*Class will NOT meet on 12/29/23 and 2/16/24.

Connect with other parents of young children while introducing your little one to music, socialization and interactive play during this weekly playgroup which meets on Fridays.

For more information, contact Gina Cristino at gina.cristino@templesholom.com.

Child's Information

* Child First Name

* Child Last Name

* Child Date of Birth

Parent Information

* Parent 1 First Name

* Parent 1 Last Name

* Parent 1 Address

* City

* State

* Zip

* Parent 1 Email

* Parent 1 Phone

Parent 2 First Name

Parent 2 Last Name

* Is Parent 2's address the same as parent 1?

Please Select OneYesNo

Parent 2 Address

Parent 2 City

Parent 2 Zip

Parent 2 Email

Parent 2 Phone

Thu, May 9 2024 1 Iyyar 5784