Homeschool Fall Registration Form
To register for 2018/19 Daytime Classes for Homeschoolers, please complete the form below or download the printable form and mail it or drop it off at our office . Please complete this form separately for each student. Parents or legal guardian must complete the form for students under the age of 18.
Email address *
STUDENT INFORMATION
Student's Name: *
Your answer
Student's DOB: *
Your answer
Parent/Guardian Name: *
Your answer
Email Address *
Your answer
Street Address:
Your answer
City, State, Zip:
Your answer
Daytime Phone Number:
Your answer
Evening Phone Number:
Your answer
Any medical conditions or allergies? *
Your answer
Emergency Contact #1 Name: *
Your answer
Emergency Contact #1 Phone: *
Your answer
Emergency Contact #2 Name:
Your answer
Emergency Contact #2 Phone:
Your answer
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