STEP Interest Form

Thank you for your interest in STEP! We are thrilled to have you join our enriching learning community. To register for STEP, please complete this registration form with information about your child. You will be contacted shortly after we receive your information.

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Child's First and Last Name: 
 *
Child's Date of Birth: *
Child's Grade Level *
Parent/Guardian's First and Last Name:
 *
Relationship to Child:
 *
Parent/Guardian's Phone Number *
Parent/Guardian's Email Address *
Emergency Contact's Name: *
Emergency Contact's Phone Number: *
Emergency Contact's Relationship to Child: *
Does your child have any medical conditions or allergies we should be aware of? If you answered yes, please provide details: 
 *
Food restrictions:
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Thank you for completing this preliminary registration form. We will send you our application packet shortly. We will also call/email you to discuss any questions you may have. Please let us know the best time to contact you.  *
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