Top-Kids Register

    Name of Child (required)

    Age (required)

    Grade (required)

    School (required)

    Language(s) spoken (required)

    Parent (required)

    Name of Parent (required)

    Address (required)

    Home/Cell Phone (required)

    Your Email (required)

    Please indicate your preferred method of communication

    Please indicate the best time to contact you
    Between 9:00-12:00Between 1:00-6:00

    Please select the mentoring workshop(s) you wish to inquire about or sign up for: (required)
    Club Membership Fall 2020

    How would you describe your child? What are their needs? Please indicate any information that can be helpful and/or relevant for the purpose of our workshops: (required)