Registration

2020 Program Registration

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First Name *

Last Name *

Current Grade *

Age *

Parent/Guardian First Name *

Parent/Guardian Last 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.

Yes

No

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Secure Online Payment

Address *

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Credit Card