Essay Class Series (Feb/March)
Please send $100 payment via PayPal to Or contact me to set up payment arrangements. :)
Student's Name *
Student's Age *
Parent's Name *
Parent's Cell Number *
Parent's Email *
Emergency Contact Name *
Relationship to Student *
Emergency Contact Phone Number *
Alternative Emergency Contact Phone Number
Can I take and use pictures that may include your child in this class for promotional purposes?
Clear selection
Anything I need to know about your child? Medical issues? Allergies? Etc
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