Registration

STUDENT NAME *

First

Last

GRADE FOR 21-22 SCHOOL YEAR *

Will the student be sharing a computer/ipad with a sibling who is also registered? If so what is their name?

Will the student want to be in a class with a friend? If so, what is their name?

PARENT / GUARDIAN NAME *

First

Last

PARENT / GUARDIAN E-MAIL *

PARENT / GUARDIAN PHONE *

Address

Address Line 1

Address Line 2

City

State

Zip Code

WHICH SESSION/S WOULD YOU LIKE TO REGISTER FOR? (Multiple selections allowed)

Total

$ 0.00

ANYTHING ELSE YOU'D LIKE US TO KNOW?

MIDDLE SCHOOL CAMPS