Emergency Contact Information
Health History
All information contained will be kept confidential in accordance with The Health Insurance Portability and Accountability Act (HIPAA) of 1996
Blanket Release Attestation
Student Enrollment Payment
A one-time $75.00 annual enrollment fee is to be paid before class begins. No additional fees will be charged for any *eligible participant; unless specified otherwise (program/project activity supply expenses, field trips, etc.).
Please click one of the PayPal options to complete payment and submit the form.