Student Name *

First Name

Last Name

Phone

(###)

###

####

Date Lesson (to be) Missed *

MM

DD

YYYY

Small Group Make-up Class Request (if selected above)

If you selected a small group make-up class, please request a class date and time below. If you cannot find a class that works for your schedule, please remember that make-up lessons never expire, so you can revisit in subsequent months. All requests must be approved and will be confirmed before final.

Monday, June 17, 2:15p, ages 3-5, Miss Suzanne

Monday, June 17, 3:45p, ages 3-5, Miss Suzanne

Saturday, June 22, 1:00p, ages 3-5, Miss Suzanne

Wednesday, June 19, 1:00p, ages 6-9, Mr. Denny

Wednesday, June 19, 2:15p, ages 6-9, Mr. Denny

Wednesday, June 19, 4:45p, ages 6-9, Mr. Denny

Wednesday, June 19, 4:45p, ages 6-9, Miss Nicole

Thursday, June 20, 6:00p, ages 6-9, Miss Liezl

Saturday, June 22, 9:00a, ages 6-9, Mr. Daniel

Saturday, June 22, 10:15a, ages 6-9, Dr. Dennis

Saturday, June 22, 11:30a, ages 6-9, Mr. Daniel

Saturday, June 22, 3:30a, ages 6-9, Mr. Daniel

Thursday, June 20, 4:45p, ages 10-13, Miss Liezl

Saturday, June 22, 1:00p, ages 10-13, Mr. Daniel

Tuesday, June 18, 5:00p, teen/adult, Miss Liezl

Wednesday, June 19, 3:30p, teen/adult, Mr. Denny