community time enrollment Form NEW OR RETURNING HOUSEHOLD?*ARE YOU A NEW OR RETURNING HOUSEHOLD?NewReturningHOUSEHOLD INFORMATIONPRIMARY LAST NAME* PRIMARY EMAIL* PRIMARY PHONE*PRIMARY ADDRESS* STREET ADDRESS ADDRESS LINE 2 CITY STATE / PROVINCEAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific STATE / PROVINCE ZIP / POSTAL CODE ADULT OR PARENT / GUARDIAN INFORMATIONNUMBER OF ADULTS* ADULT OR PARENT / GUARDIAN INFORMATIONYOU MAY HAVE TO TEMPORARILY DISABLE ANY POPUP BLOCKERS BEFORE COMPLETING THIS SECTION, THE 'ADD ENTRY' BUTTON WILL GENERATE A SECURE POPUP TO ENTER PARENT / GUARDIAN INFORMATION. CONTACT NAME RELATION TO STUDENT CLASS PREREGISTRATION Actions Edit Delete There are no Adults or Parents / Guardians. Add Adult or Parent/Guardian Maximum number of adults or parents / guardians reached. TOTAL ADULTS / GUARDIANS ENTEREDCHILD INFORMATIONNUMBER OF CHILDREN* CHILD INFORMATIONYOU MAY HAVE TO TEMPORARILY DISABLE ANY POPUP BLOCKERS BEFORE COMPLETING THIS SECTION, THE 'ADD STUDENT' BUTTON WILL GENERATE A SECURE POPUP TO ENTER STUDENT INFORMATION. NAME AGE THIS SEPTEMBER CLASS PREREGISTRATION Actions Edit Delete There are no Children. Add Child Maximum number of children reached. TOTAL CHILDREN ENTEREDEMERGENCY CONTACT INFORMATIONPRIMARY EMERGENCY CONTACT (PLEASE EXCLUDE ADULT OR PARENT/ GUARDIAN LISTED ABOVE)PRIMARY EMERGENCY CONTACT NAME* FIRST LAST PRIMARY EMERGENCY CONTACT PHONE*PRIMARY EMERGENCY CONTACT RELATION*RELATIONAuntCousinFriendGrandparentNeighborParentSiblingUncleSECONDARY EMERGENCY CONTACT (PLEASE EXCLUDE ADULT OR PARENT/ GUARDIAN LISTED ABOVE)SECONDARY EMERGENCY CONTACT NAME* FIRST LAST SECONDARY EMERGENCY CONTACT PHONE*SECONDARY EMERGENCY CONTACT RELATION*RELATIONAuntCousinFriendGrandparentNeighborParentSiblingUncleOTHER INFORMATIONWONDER SPECIAL SERVICES (select all that apply)In addition to offering financial assistance to qualifying households to apply to class fees when possible, Wonder also offers select services for households who care for children through adoption and fostering, as well as for mothers who chose life through services from an alternative/crisis pregnancy center. For the purpose of our stewardship, we do ask families to provide documentation by the first class. You'll receive more information with available options once you've completed this form. Not applicable. One or more of the enrolled children is adopted into my family. One or more of the enrolled children is a child I foster. I chose life for one or more of the enrolled children through services from an alternative pregnancy center. Please send me financial assistance information. HOW DID YOU HEAR ABOUT WONDER? (SELECT ALL THAT APPLY)* Private Instructor Current / Former Member Brochure or Flyer Facebook Instagram Youtube Google or Other Search Engine Homeschool Conference Adoption Agency or Services Foster Agency or Services Alternative/Crisis Pregnancy Center or Services Other OTHER REFERRAL*Please list your referral name if not listed above. For adoption, foster, and alternative pregnancy center agencies or services, please list the organization name. HiddenMANDATORY ORIENTATIONMandatory Orientations are scheduled for new members. You will hear more about our faith-based, family-focused, and community-centered approach to exploring, creating, and sharing with others the wonders of God around us. Please register for the orientation date/time you plan to attend.HiddenADULTS ATTENDING* HiddenCHILDREN ATTENDING (AGE 5+ ATTENDANCE REQUIRED)* BINDING AGREEMENT* BINDING AGREEMENT: The undersigned, the parents or legal guardians of minor, if applicable, has read and fully and accurately completed this enrollment application, understands the terms and conditions set forth herein, and agrees to be legally bound hereby. FULL NAME* SIGNED DATE* MM slash DD slash YYYY COMMENTS OR QUESTIONSNameThis field is for validation purposes and should be left unchanged. Δ