TPS Summer Enrichment Program Registration
For detailed information please refer to our website: www.thepiedmontschool.com/academics/summer
Registrants Full Name: *
Your answer
**Community Families ONLY** The above registrant is a sibling of another registrant (25% off discount will be applied to overall balance) *
Registrant Parent/Guardian Name: *
Your answer
Registrants Current School *
Your answer
Registrants Grade Level *
Which weeks will you attend (please check ALL that apply) *
Required
Parent/Guardian Home Address *
Your answer
Parent/Guardian Email Address **this will be used for billing purposes** *
Your answer
Parent/Guardian Day Time Phone Numbers (please include numbers where you could best be reached during the enrichment program times) *
Your answer
Emergency Contact and Number *
Your answer
Academic Concerns (if any): *
Your answer
Health Concerns (please include allergies, any medications needed to be taken during enrichment program hours, etc) *
Your answer
I understand that my registration will not be complete until my deposit has been paid (TPS Families: $250, Community Registrants: $500- deposit will deduct from tuition balance). Deposits will be billed via FACTS for TPS families and via email/electronic invoice for Community families. Once registration form and paid deposit have been received, I will receive electronic confirmation that my child has been officially enrolled in the TPS Summer Enrichment Program. *
Required
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