Child Name ________________ Age_______

Child Name ________________ Age_______

Adult: Name/Relationship to Child _____________________________________

Adult: Name/Relationship to Child _____________________________________

Address ______________________________

Address2 _____________________________

City _________________________________

State ________________ Zip_____________

Telephone ____________________________

Email ________________________________

Class Payment:

Number of Adults Attending _____________

Number of Children Attending ___________

1 Adult & 1 Child: $95 _________________

Add'l Adult or Sibling: $45 ______________

Total ________________________________

Make checks payable to:

API/ My First Signs

20 Rockhill Road

Bala Cynwyd,  PA 19004