Name Birthdate dd/mm/yy Guardian Address Authorized Pick-up       City Postal Code Home Phone Cell/Work Phone Emergency Contact     Emergency Phone     E-mail     Allergies or special needs Desired Week Course Name zIncredible Cartooning - Fall Term 12 weeksz     Day/time of classes Wednesdays, 4 to 5:30 pm, Saturday, 2:30 to 4:00 pm     Course Fee $334.00     Materials Fee included     Total Cost $334.00