Student Registration Form
If you have more than one children click next to add more.
Returning Student? *
New Student? *
Student Full Name *
School Grade Level *
Student Phone Number
Email (if any)
Allergy* *
*Type Non/no if no allergies
2nd Child Information
Returning Student?
New Student?
Student Full Name
School Grade Level
Student Phone Number
Email (if any)
Allergy*
*Type Non/no if no allergies
3rd Child Information
Returning Student?
New Student?
Student Full Name
School Grade Level
Student Phone Number
Email (if any)
Allergy*
*Type Non/no if no allergies
Father's Full Name *
Signature *
Mother's Full Name *
Signature *
Address: (Street, City, State & Zip) *
Parent's Phone Number *
Parent's Email
Emergency Contact Name: *
Emergency phone number *
Date *
MM
/
DD
/
YYYY
Submit
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