Kirby HSML Summer Registration Form

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Upon receipt of this form and your first payment of $130, paid through the website, you will receive an email from High School Math Live that confirms your registration and provides information about setting up your membership with our website.

VERY IMPORTANT: There are 2 steps to register your student with High School Math Live.
Step 1: Fill out this registration form. You will receive an automated email with your responses. Check your spam folder if you don't see it in your inbox.
Step 2: Submit the first payment of $130 on the course page on our website.

Below, please provide the primary parent email who will be receiving all correspondences between teacher and student.

Email *

Parent's First Name *

(Please give the parent name that will be receiving all correspondences between teacher and student.)

Parent's Last Name *

Primary Parent Cell Phone Number *

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