(516) 521-5463

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    • Home
    • Our classes
    • Summer
    • Fall
    • Winter
    • Spring
    • Parent Comments
    • Join our email list
    • Contact us

(516) 521-5463

  • Home
  • Our classes
  • Summer
  • Fall
  • Winter
  • Spring
  • Parent Comments
  • Join our email list
  • Contact us

Paying by check:

After emailing us at info@thehappybookworm.com to let us know which class you plan on registering for you will have 5 business days for payment to be received. if payment is not received, we will need to release the spot.

Please print this form and mail it along with a check (made out to The Happy Bookworm, Inc.):

The Happy Bookworm, Inc.
P.O. Box 376
Syosset, NY 11791

Class Location:  ___________________________________________

Class Day:  _____________________________

Class Time: ____________________________

Class Price:  ____________________________

Child's Last Name _________________________________________

Child's First Name _________________________________________

Child's Birthdate   __________________________________________

Address  _________________________________________________

_________________________________________________________

Home Phone Number________________________________________

Emergency Contact Number __________________________________

Cell Phone Number__________________________________________

Mother's Name ____________________________________________

Father's Name _____________________________________________

Email Address _____________________________________________

Does your child have any allergies?

_________________________________________________________

If you are signing up with a friend, please write his/her name here:

________________________________________________________

Please choose one of the following and sign:

_____ I give permission for my child's photo to be used for marketing purposes.

_____ I DO NOT give permission for my child's photo to be used for marketing purposes.

___________________________________                                    
Signature &  Date

We will contact you by email or phone to let you know that we have received your registration and
payment. 


Copyright © 2018 

The Happy Bookworm - All Rights Reserved