2024 Kindergarten Kickstart Student Registration
Please provide the requested information below:
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Student Name *
Date of Birth *
MM
/
DD
/
YYYY
Parent Name *
Parent Email *
Parent Phone number *
Address *
Medical Needs/Allergies
Emergency Contact/Relationship to Student/Phone Number *
Home School
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Primary Language Spoken at Home
Additional Information/Things We Should Know
Payment Information- Due June 15th 
Fee: $175

Please submit payment through the PaySchools website.

Thank you!
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