Let's Learn 2018
Class Registration
Email address *
Student's First Name *
Your answer
Student's Last Name *
Your answer
Student's Current School *
Student's Current Grade *
Class Choice 1 *
Your answer
Alternate for Class Choice 1 *
Your answer
Class Choice 2
Your answer
Alternate for Class Choice 2
Your answer
Parent's/Guardian's First Name *
Your answer
Parent's/Guardian's Last Name *
Your answer
Address (Number, Street) *
Your answer
Apt or Unit Number
Your answer
Address (City, State, Zip Code) *
Your answer
Home/Primary Contact Phone Number *
Your answer
Emergency Phone # *
Your answer
Name on check or money order (please include student's name on the memo line) *
Your answer
Is your child/children attending the SUMMER EXTENDED DAY Program (Students are escorted between programs) *
I understand that registration is NOT complete until payment is received. (within 7 days) *
Required
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