2020-2021 GADC Registration Form
Are you interested in ONLY virtual classes? *
Student's Name (please write your child's name the way you want it listed in the program) *
Student's Date of Birth *
Parent's Name *
Street Address *
City, State, Zip *
Phone Number: *
Email Address (Please provide an email address you check regularly) *
Select all classes you are registering for: *
Payment Plan Options (check one option) *
If you are paying monthly, we require a credit or debit card to be on file. Please enter your card number below. *
Card expiration date *
Card CVV code (on the back) *
Name on Card & Billing Zip Code *
Please list any special needs, questions, or concerns you may have below.
$30.00 Registration Fee (per student) MUST accompany this form in order to be registered!
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