If you are REGISTERING for the first time please fill out the application for small groups or the 8 week rising kindergarten summer group making the $100 deposit before proceeding with this final payment form.
2025 Small Groups Application
**If you are currently in groups and are CONTINUING, please proceed with this form
2025 Payment Form
Child's Name
*
First Name
Last Name
DOB
. My child prefers to be called
.
Responsible Party
*
First Name
Last Name
Confirm Phone Number
*
Please enter a valid phone number.
Confirm Email
*
example@example.com
Confirm which Exceptional Me OPEN small group time / age you signed up for.
*
Please Select
4-5 yrs. READY for Kindergarten 8 week SUMMER only OPEN (Thur. 9am-11am) 6-12 to 7- 31st
4-5 yrs READY for Kindergarten OPEN (Tues. 9am-11am) during school year
9-12 years OPEN (Mondays 9am - 11am)
5-8 years OPEN (Mondays 12:30pm to 2:30pm)
5-8 years OPEN (Mondays 4pm - 6pm)
9-12 years (Tuesdays 12:30pm - 2:30pm)
9-12 years OPEN (Tuesdays 4pm - 6pm)
9-12 years (Wednesdays 9am - 11am)
5-8 years (Wednesdays 12:30pm - 2:30pm)
9-12 years (Wednesdays 4pm - 6pm)
Signature of responsible party
*
My Products
*
prev
next
( X )
New student: Balance after deposit
This balance reflects 20% off the regular price -$100 deposit and is a promotional price.
$
395.00
Quantity
1
2
3
4
5
6
7
8
9
10
FREE T-Shirt
required (If your already purchased skip this)
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Continuing Student (reflects a 20% discount)
Standard pricing: $75 a week x 8 + $600
$
495.00
Quantity
1
2
3
4
5
6
7
8
9
10
Submit
Submit
Should be Empty: