173 Brookfield Road - A1E 6J4 - St. John’s, Newfoundland 709-747-3276 Please fill out and mail back to us by May 1, 2015. Spaces are given on a first come first serve basis. Please Note that applications will not be accepted through email, our website or Facebook. Lil’ Lester’s Club 2015-Pre Registration Please remember that there is limited space so please sign up fast! Childs Name: ________________________________________________ Childs Age: _____ Childs Date of Birth: ____________________________ Parents/Guardians: ____________________________________________ Contact Numbers: (home) ___________ (cell)__________ (other)_________ Email: ______________________________________________________ Mailing Information: ___________________________________________ ____________________________________________ ____________________________________________ Allergies/Medical Conditions:______________________________________ _____________________________________________________ Size of t-shirt: ________ (Can wait to fill out when you see the size of the shirt) To cover the cost of the materials which will be used as well as the tshirt the club will cost each child will be: **Please note all prices are plus tax. $50.00 + tax ($56.50) for Littlest Lester’s $70.00 + tax ($79.10) for Lil’ Lester’s $40.00 + tax ($45.20) for returning Littlest Lester’s going into Littlest Lester’s $55.00 + tax ($62.15) for returning Littlest Lester’s going into Lil’ Lester’s $40.00 + tax ($45.20) for Junior Lester’s Please number (1 being first choice) which group you would like your child to participate in. Again, please remember that spots are granted on a first come first served basis as space is limited. If we get an overwhelming response we will certainly look into adding more times for certain ages. Please note below if there are other activities or other reasons that would conflict with a particular time. Littlest Lester’s (Ages 3-4) start dates: June 23,June 25 (five week program) Tuesday 11:00-11:45 ____ Tuesday 4:15-5:00 ____ Tuesday 5:30-6:15____ Thursday 11:00-11:45 _____ Thursday 4:00-4:45_____ Lil’ Lester’s (Ages 5-10) start date: July 2 (seven week program) Thursday 1:00-2:00 ____Thursday 2:30-3:30 ___Thursdays 6:30-7:30 __ Lil’ Lester’s Condensed Program start date July 8 (four week program) Wednesday 10:30-12:30____ Wednesday 3:30-5:30____ Junior Lester’s (Returning Lil’ Lester’s Only) (seven week program) Thursdays 5:15-6:15______ Junior Lester’s Condensed Program (Returning Lil’ Lester’s Only) start: July 8 Wednesday 1:00-3:00_____ (4 week program) Notes on conflicts/ request to be with friend:_________________________ ____________________________________________________________ Through our Lil ’Lester’s Club we hope to encourage children to be more aware of where their food comes from, to be more aware of the farming lifestyle in general, and to learn the basics of farming hands on. Please sign to ensure that everything is correctly filled out: _________________ If you have any questions or concerns, feel free to contact us by phone or email. Hope to see you soon! For Office Use Only: Club time and day: _______________________________________________ Waitlisted:____________________________________________________ Confirmation email sent: ___________________________________________ Amount paid: _______________ Employee Signature: ____________________
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