Pacific Ridge After School Program Registration
Please make your check payable to Pacific Ridge School and bring it with you to the first session. Please contact Steven Dziekonski with any questions or concerns at sdziekonski@pacificridge.org or 760-448-9822.
Student's first name *
Your answer
Student's last name *
Your answer
Student's grade as of fall 2018 *
Parent or guardian's first name (primary contact) *
Your answer
Parent/Guardian last name *
Your answer
Parent/Guardian email address *
Your answer
Parent/Guardian phone number *
Your answer
In which classes or lessons are you enrolling? *
Required
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