Grasshopper Green Preschool
Summer Program Registration
June 24th-June 28th 2019
9:00 a.m. to 1:00 p.m.
Monday through Friday
Name _____________________________ Sex __
Address____________________________________________
Age _____ Birthdate ______________Telephone ___________
Parents: Mother __________________Telephone ___________
Father __________________ Telephone ___________
Email address ____________________________________
Non-Refundable Deposit: $50.00
Date received ___________________
Week 1: JUNE 24th- June 28th
Monday through Friday 9-1:00 pm Total $150.00
Please complete and return with Registration Fee to:
Grasshopper Green Preschool
1 Sterling City Road
Lyme, CT 06371
(860) 434-1844