COMPLETE FORM TO REGISTER
FALL 2021

Choose a Week! Sign up for 1, 2, 3 or all 4 weeks!
$180 per week .
$50 Per Day based on availability.

Apply 10% discount if registering for 2 weeks or more.

Payment: Cash or checks payable to Leah Zara-Acevedo, LLC
Drop off or mail to: Leah Zara-Acevedo, 828 O’Donnell Avenue, Scotch Plains, NJ 07076
VENMO @leah-zara-acevedo
ZELLE letsmonet@gmail.com


Skip Section 2 if registering only one camper.
Sign in to Google to save your progress. Learn more
Email *
Parent Name *
Address *
Phone Number *
Student Name *
Age *
SESSIONS *
Required
CHOOSE A DAY option only - pls specify dates.
Amount Due (deduct 10% for 2 or more weeks) *
Do we have your permission to use photos of your child/children for marketing and/or social media such as Facebook and Instagram? *
Make-up Classes are to be taken during SUMMER 2021 Session Only. Seating is based on availability. In case of serious emergency, a credit will be issued. Initial Below for acknowledgement. *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy