Parent & Child Spring 2018 Application

April 19th through June 8th, no class May 4th. Please mark the appropriate class you would like to attend, scan and email to [email protected] or mail or bring to address below.*
- 18-36 months: Thursday 9:30am – 11:30am ($360)
- 14-36 months: Friday 9:30am – 11:30am ($315)
Child's Name*
First Last
Gender*
- M
- F
Child's Birthdate:*
MM slash DD slash YYYY
- More than one child
Multiple Children
Please enter in the Full Name and Birthdate for each additional child. There is a 20% discount for Twins.
Mother's Name*
First Last
Email Address
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell Phone*
Father's Name*
First Last
Email Address
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell Phone*
PAYMENT*
- Visa
- MC
- AMEX
- Check Payable to Under the Oaks Preschool
Under the Oaks ECC, 3480 Las Flores Cyn, Malibu CA 90265 (310) 456-7111, (310) 266-7139
Name on Card
Card Number

3% surcharge on all Credit Card charges / Session must be paid in full prior to session start
Expiration Date

MM/YYYY
CVV Code

3-4 digit code on your credit card
Billing Zip Code

Download PDF

Download the form PDF here to fill out and mail or fax to us. Or you can continue with this online form above and press Next.