Student Registration

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Student Registration

Registration is not complete until you have received an email confirmation that a spot is available for your child.

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* Indicates required question

Child Name *

(Last name, First name)

Your answer

Age *

Your answer

School *

Your answer

Grade *

2

3

4

5

Teacher

Your answer

Parent/Guardian Name *

(Last name, First name)

Your answer

Relationship to Child *

Your answer

Address *

Your answer

Telephone Number *

Your answer

Email *

Your answer

Preferred method of contact *

For updates regarding changes in the program due to weather, etc.

Phone call

Text message

Email

Alternate Contact Person *

Your answer

Relationship to Child *

Your answer

Telephone Number *

Your answer

Submit

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