Enrichment Registration - Spring 2019
Registration Deadline: April 12, 2019

Complete one registration per child.

Student last name *
Your answer
Student first name *
Your answer
Grade *
Teacher (Last Name only) *
Your answer
Email address *
Most enrichment communication is done by email. If you do not have access to email or prefer phone, please indicate below.
Your answer
Parent/guardian name(s) *
Your answer
Address *
Your answer
Phone 1 (Preferred) *
Your answer
Phone 2
Your answer
List any severe allergies child has
Your answer
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