Little Explorers Fall 2025

Parent/Guardian #1

* First Name

* Last Name

* Confirmation email

* Mobile Phone

* Address

* City

* State

* ZIP Code

Parent/Guardian #2

First Name

Last Name

Email Address

Mobile Phone

* Number of Little Explorers you are enrolling

* First Name

* Last Name

* Date of Birth

* I understand that if my child or his/her accompanying adult is feeling unwell, we/they will not come to class. (Check box for Yes)

I understand that if my child or his/her accompanying adult is feeling unwell, we/they will not come to class. (Check box for Yes)

* I understand that CSI has a policy that all children in program attendance must be vaccinated in accordance with NYS DOH requirements and that my child has the required vaccines. (Check box for Yes)

I understand that CSI has a policy that all children in program attendance must be vaccinated in accordance with NYS DOH requirements and that my child has the required vaccines. (Check box for Yes)

Please use this space to let us know anything you would like to share about your child/family before class begins (allergies, medical concerns, etc.)

Wed, December 17 2025 27 Kislev 5786