Hi-Liners Fall 2018 Class Registration
Please fill out a separate registration for each student. Payment for multiple students can be paid together.
Select class(es): *
Required
Student Name: *
Your answer
Age: *
Your answer
Pronoun *
Birthdate: *
MM
/
DD
/
YYYY
Parent 1 Name *
Your answer
Parent 1 Email *
Your answer
Parent 1 Phone *
Your answer
Parent 1 Address *
Your answer
Parent 2 Name
Your answer
Parent 2 Email
Your answer
Parent 2 Phone
Your answer
Parent 2 Address (if different that parent 1)
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
School *
Your answer
Notes:
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