Parent's Name *

First Name

Last Name

Phone *

(###)

###

####

Child's Name *

First Name

Last Name

Child's Gender *

Male

Female

Select Workshop *

Drum Workshop

Dance Workshop

Does your child attend school at PS 289? *

Yes (timeslot: 5:00 pm - 6:30 pm)

No (timeslot: 4:00 pm - 5:30 pm)