RAHWAY

Please Select the School you are interested in: *

Franklin Elementary School

Method of Payment *

Out-Of-Pocket $200 per week - Online

Confirmed CCCC’s

Applying for CCCC’s

START DATE *

BEGIN ON OR AFTER JUNE 23, 2025

MM

DD

YYYY

Child's Name *

First Name

Last Name

Child's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

MM

DD

YYYY

T-Shirt Size *

Youth X-Small

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult X-Large

Mother's Name

First Name

Last Name

Mother Employers Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother Cell Phone Number

(###)

###

####

Father's Name

First Name

Last Name

Father Employers Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Father Cell Phone Number

(###)

###

####

E1 Name *

First Name

Last Name

E1 Phone *

(###)

###

####

E2 Name

First Name

Last Name

E2 Phone

(###)

###

####

Name *

First Name

Last Name

*

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.