Enrollment Form

Enrollment Form
Child's Name*

First NameLast Name
Birthdate*

MonthDayYear
MaleFemale
Child's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian*

First NameLast Name
Relationship to Child
Type a label*
Preferred Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*

Home EmailWork Email
Work Number*
Please enter a valid phone number.Format: (000) 000-0000.
Employer
blanks*
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Parent/Guardian*

First NameLast Name
Relationship to Child
blanks*
Preferred Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*

Home EmailWork Email
Employer
blank*
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Number*
Please enter a valid phone number.Format: (000) 000-0000.

Preferred Class for 2024-2025 School Year Prices are for the Academic Year*

Rows	Chosen Class	Comments for Classes
2's M/W - 9:15-11:30 ($1,900)
Wait List - 2's T/Th - 9:15-11:30 ($1,900)
Wait List - 3's M/T/W/Th - 9:00-11:30 ($3,900)
Wait List - 3's M/T/W/Th Extended Day - 9:00-2:30 ($8,550)
Wait List - 3's M/T/W 9:00-11:30 ($2,990)
Wait List - 3's M/T/W Extended Day - 9:00-2:30 ($6,400)
Wait List - 3's T/Th 9:30-12:00 ($2,000)
Wait List - 3's T/Th Extended Day - 9:30-2:30 ($3,900)
3's M/W/F - 9:30-12:00 ($2,990)
3's M/W Extended Day - 9:30-2:30 ($3,900)
Wait List - 4's M/T/W/Th/F - 9:00-12:00 ($5,825)
Wait List - 4's M/T/W/Th Extended Day - 9:00-2:30 ($8,550)
Wait List - 4's M/T/W/Th - 8:45 - 11:45 ($4,650)
Wait List - 4's M/T/W/Th Extended Day - ($8,950)
Wait List - 4s T/W/Th - ($3,600)
Wait List - 4's T/W/Th Extended Day -($6,700)