2021/2022 School Year Student Registration (Open Registration)
Once you have submitted this form. Please allow 24 hours for us to call you. We will not run your card until we have spoken to you, letting you know if you child/ren have a spot in our program. Thank you!
Email address *
First and Last Name of Student #1 *
Student #1 Date of Birth *
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Student #1 Age as of September 1, 2021 *
How many days a week would you like to register Student #1? *
First and Last Name of Student #2
Student #2 Date of Birth
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Student #2 Age as of September 1. 2021
How many days a week would you like to register Student #2?
Clear selection
First and Last Name of Student #3
Student #3 Date of Birth
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Student #3 Age as of September 1, 2021
How many days a week would you like to register Student #3?
Clear selection
First and Last Name of Student #4
Student #4 Date of Birth
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Student #4 Age as of September 1, 2021
How many days a week would you like to register Student #4?
Clear selection
First and Last Name of Parent *
Daytime Phone Number *
Home Address *
City, State, Zip Code *
Name on Credit Card *
Type of card *
16 Digit Credit Card Number *
Expiration Date (MM/YY) *
CVC Code *
If your child needs to repeat the same age group they completed in the 2020/2021 School Year or you have special circumstances we need to be made aware of, please comment below.
**Please note that your credit card will be charged for the cost of registration based on the number of days you have registered your student.
2 Days- $100
3 Days- $110
5 Days- $120
By submitting this form, you have agreed to have your credit card charged for the registration fee amount listed above. A 3.5% handling fee will added to the charge. Registration fees are non-refundable.
Your submission will record date and time.
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