Student Registration Form
Student Preferred Name
*
First Name
Last Name
Student E-mail
example@example.com
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Parent's E-mail
*
example@example.com
Additional Comments
Select Classes Here
Mondays 11-12 for 6-9 year olds
Tuesdays 11-12 for 9-12 year olds
Thursdays 2-3 for 12+
Submit Application
Should be Empty: