Class Registration Summer 2016

I am enrolling more than one student. *
Student Name *
Student Name
Address *
Address
Birthdate *
Birthdate
Which class?
Second Student Registration (If Applicable)
Second Student Name (If Applicable)
Second Student Name (If Applicable)
Birthday (Second Student if Applicable)
Birthday (Second Student if Applicable)
Which Class *
Please select all that apply
Third Student Registration (If Applicable)
Third Student Name (If Applicable)
Third Student Name (If Applicable)
Birthday (Third Student)
Birthday (Third Student)
Which Class? *
Please select all that apply
Emergency Contact
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Parent/Guardian Name *
Parent/Guardian Name
Parent or Guardian Phone *
Parent or Guardian Phone
Second Emergency Contact Person *
Second Emergency Contact Person
Emergency Contact Phone *
Emergency Contact Phone
Terms of Agreement *