Registration

Fall 2021 Program Waitlist

Registration for Fall 2021 is closed. Please complete this form to be added to a waitlist. You will be contacted if space becomes available.

Student First Name *

Student Last Name *

Age *

Current Grade *

Parent/Guardian Name *

Parent Phone Number *

Student Phone Number

Parent Email

Student Email

What school does she attend?

How did you hear about the program?

Please list any food allergies.

I confirm that my daughter is available to commit to the assigned dates and will complete the program to its entirety if space becomes available.

Yes

No

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