Registration Form
August 2-6
(Morning Session Full)
Evening Session 6:30pm to 8:30pm

For ages 3 years thru 12 years
Registration deadline is July 23 or when classes fill.

Childs Name A value is required.Minimum number of characters not met.Exceeded maximum number of characters. Age Minimum number of characters not met.Exceeded maximum number of characters. Grade Completed Minimum number of characters not met.Exceeded maximum number of characters.

Day Session .....full, no longer enrolling
Night Session ....... (6:30pm till 8:30pm)
Please make a selection.

Parent or Guardian Minimum number of characters not met.Exceeded maximum number of characters.
Home Phone.........
Cell Phone............

Address......
Minimum number of characters not met.Exceeded maximum number of characters. City............ Minimum number of characters not met.Exceeded maximum number of characters.
State........... Minimum number of characters not met.Exceeded maximum number of characters.
Zip Code..... Minimum number of characters not met.Exceeded maximum number of characters.

E-Mail........ Minimum number of characters not met.Exceeded maximum number of characters.Invalid format.

Emergency Contact Name
(other than Parent or Guardian)

Minimum number of characters not met.Exceeded maximum number of characters. Emergency Phone#
A value is required.Minimum number of characters not met.Exceeded maximum number of characters.

Special Needs or Allergies, or additional information

Every field in this form must be completed before submitting.

Registration Form August 2-6 (Morning Session Full) Evening Session 6:30pm to 8:30pm

For ages 3 years thru 12 years Registration deadline is July 23 or when classes fill.

Registration Form
August 2-6
(Morning Session Full)
Evening Session 6:30pm to 8:30pm

For ages 3 years thru 12 years
Registration deadline is July 23 or when classes fill.