Rumble in the Jungle 2011 Registration Form
Please submit one form per child enrolled. Thanks.
Student's Name DOB Age
Will you be paying in full for the summer?
Will you be paying in 3 monthly installments? Automatic debit is required with this option.
Will you need to make 13 weekly installments? Automatic debit is required with this option.
Toddler Program - 18 months - 2 years before Sept. 1st of 2010 school year
Filled - Enrollment is closed
Preschool Program - 3 - 4 years before Sept. 1st of 2010 school year
Pre-K/Kindergarten Program - 4 - 6 years before Sept. 1st of 2010 school year
Short Session for School Agers returning to school early (ages 5-8yrs)
E-signature
E-mail
Referred by
CREDIT CARD AUTHORIZATION
Name on Card
Type of Card
Card Number
Expiration Date
By submitting this form, I agree to have Wild About Learning charge my credit card for the following charges:
Paypal and checks are also accepted. Once you submit this form, go to our Payment Center link at the top of our website.
Class confirmation will not be made until all fees are paid.

June 6th, 2011 - Sept. 2nd, 2011
Morning Camp is FILLED
6 Seats Remaining in Afternoon Camp