Summer Children GooZoom Class
Registration Form
Email address *
Name (Student) *
Date of Birth *
MM
/
DD
/
YYYY
Phone *
Address *
Emergency Contact *
Emergency Contact 2
Session to register *
Tuition: 1 week $ 100; 3 Weeks $ 270; 6 weeks $ 540; 9 weeks $ 810
One Week
Parent or Guidance *
Submit
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