Enroll Now

Child #1

* Name Of Child:
*Birth Date:
(MM-DD-YYYY)
*Medical conditions/allergies:
*School Name and Grade:

Add Another Child

Child #2 (Remove)

Name Of Child:
Birth Date:
(MM-DD-YYYY)
Medical conditions/allergies::
School Name and Grade:

Parent/Guardian Information

*Parent/Guardian Name:
*Address:
*Email Address:
*Home phone number:   -     -  
*Mobile phone number:   -     -  
*Emergency contact person:
*Emergency contact phone number:   -     -  

Child #1

* Program #1:
*Preferred Location(UES or UWS), Day and Time:
* (Please refer to our schedules and enter your preferred location, date and time above.)
Program #2:(Optional)
Preferred Location(UES or UWS), Day and Time:
* (Please refer to our schedules and enter your preferred location, date and time above.)

Add Another Child's Program

Child #2 (Remove)

Program #1:
Preferred Location(UES or UWS), Day and Time:
* (Please refer to our schedules and enter your preferred location, date and time above.)
Program #2: (Optional)
Preferred Location(UES or UWS), Day and Time:
* (Please refer to our schedules and enter your preferred location, date and time above.)

By his/her signature above, participants hereby acknowledge and consent that images of their child(ren) may be used for business promotion. The individual permits FasTracKids to take whatever steps to obtain emergency medical care, if warranted. The individual hereby releases and discharges FasTracKids from any and all claims and demand of any kind for injury which the child may suffer or sustain directly or indirectly as a result of participation in FasTracKids' programs.

I agree to the above conditions and disclaimers.

Preschool, summer camp, and tutoring center in NYC