Study Squad Registration Form
Child's Name
*
First Name
Last Name
Child's Age
*
Grade Level
*
Child's Gender
Male
Female
Is one parent an LA County First Responder
Yes
No
For Verification
First Responder/Firefighter or Police ID
City/County Employee Number
Name of School
*
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
City
*
State
*
Where Did you hear about us?
*
Anything we should know about your child?
*
Submit
Should be Empty: