Registration

Fall/Spring 2011-2012

Registration Fee:

$20 Returning Student; $25 New Student;

$50 Returning Family; $60 Family

Please complete a separate registration form for each child.

Student’s Name: ____________________________________________________

Parent’s Name: ____________________________________________________

Home Phone: ______________________ Cell Phone: _________________

Address: ____________________________________________________

City: __________________________________ Zip: ___________

Email Address: ____________________________________________________

Child’s Birthday: ___ / ___ / ______

mm dd yyyy

Name of School: ______________________________ Grade: (upcoming yr) _____

How did you hear about us: ______________________________________________

____________________________________________________

What classes are you registering for? (include day & time)

Please sign below to indicate that we have your permission to use photographs of

your child for publicity purposes.

_______________________________________________________________________

Signed Date