Join CHALK Rancho Palos Verdes for our CHALKlets (Parent/Toddler) Program for ages 15 - 24 months
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Enrollment Application
CHALK of Rancho Palos Verdes
Child's Information
Child's First Name
Child's Last Name
Gender
Male
Female
Date of Birth
Parent/Guardian 1 Information
First Name
Last Name
Email Address
Phone Number
Additional Phone Number
(Optional)
Address
Address Line 2
(Optional)
City
State
Please select a state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
+ Add Another Parent/Guardian
Parent/Guardian 2 Information
First Name
Last Name
Email Address
Phone Number
Additional Phone Number
(Optional)
Address
Address Line 2
(Optional)
City
State
Please select a state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Schedule
Requested Start Date
(Based upon availability)
Full Days
8:00 AM - 5:00 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Half Days
9:00 AM - 12:00 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Comments on Flexibility of Days
(This is a great opportunity to let us know just how flexible you can be.)
By submitting this enrollment application, the Parent/Guardian above understands and accepts the following policies: The $250 registration fee is non-refundable and non-transferable if the child is accepted into the program. The first month's tuition is due within two weeks of the time a spot is offered, and it is non-refundable and non-transferable.
I Understand and accept the policies.
Submit Application
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