June 2X/week Summer Session

June Group Summer Lessons (twice a week)

June 10th-June 28th Mornings $720 (6 lessons)
**A $30 enrollment fee is required for new students. You can pay this through paypal or by check.**
Monday/WednesdayTuesday/Thursday
Student Information
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade
MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the student prescribed an inhaler? If yes, please explain any instructions.
New Student Enrollment Fee*
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Pay with PayPal
$30.00

Pay with check
Add $30 to your session total

$ Free

Total

$0.00
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June Group Summer Lessons (twice a week)