REGISTRATION

Student's Last Name, First Name (required)

Parent/Guardian's Last Name, First Name (required)

Parent/Guardian's Phone Number (required)

Parent/Guardian's Email (required)

Student's Age (required)--67891011121314

SUMMER: Please Select the Preferred Registration Dates for your child
--June 29 - July 3July 6 - July 10July 13 - July 17July 20 - July 24July 27 - July 31August 3 - August 7August 10 - August 14August 17 - August 21August 24 - August 28

Does your child require any special needs? Can we provide any accommodations to enhance student participation?

School Name and Address (required)

Teacher Last Name, First Name (required)

Principal Last Name, First Name (required)

School Phone Number and Email(required)

Grade Level (required)--K12345678

Please Select the Preferred Registration Month for your Classroom:
--SeptemberOctoberNovemberDecemberJanuaryFebruaryMarchAprilMayJune

Do any students require accessibility needs? Can we provide any accommodations be made to enhance student participation?