Summer 2009 Film Club Registration

Film Club logo
  • Fill out 1 form per child
  • Complete form on-line and pay with Paypal, or mail payment
  • An email will be sent to confirm spot and to schedule an interview to learn more of your child’s ability levels and special gifts
Student Information
First Name: Last Name:
Age as of July 1, 2009: Birthday:
Current grade:
Parent/Guardian information
Mother/guardian Name:
Address:
City: State:
 Zip:
Email: Phone(s):
Father/guardian Name:
Address:
City: State:
 Zip:
Email: Phone(s):
People designated to pick up child from Film Club
Mother
Father
Alternate pick-up person:
Address:
City: State:
 Zip:
Email: Phone(s):
Download the Medical Info & Consent to Participate. Email to education@clearlakeds.org. Check this box once you have downloaded this form.
Payment Information - $95
If you do not wish to pay by PayPal, please still click Submit. Skip the PayPal page, and mail your deposit to Joanie Garro, 3103 Red Maple Drive, Friendswood, TX 77546.