1 child =$27; 2 siblings = $47; 3 siblings = $67; 4 siblings = $80 | Non-Members = $40/child | Late pick up fee of $15/15 minutes (automatically charged to card on file). *****BEFORE CALLING****PLEASE NOTE**** DISCOUNTS WILL BE MANUALLY DEDUCTED BY STAFF PRIOR TO PROCESSING YOUR CREDIT CARD. **** YOU WILL NOT BE CHARGED THE NON-MEMBER AMOUNT UNLESS APPLICABLE.****
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)
Students entered below will be added to your family's account
MAKE-UP OPTION: Please type in the date of the missed class and the fee will be adjusted. One make-up per session permitted.
I understand that C.I.T.Y. Club staff will manually deduct applicable discounts prior to my credit card being charged.*
Promo Code, Coupon or Postcard Description, or Gift Certificate Code
Additional Information:
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*