Workshop Registration

workshop registration form

* Indicates required field

Child's Name *

First

Last

Age *

Grade as of Sept. 30, 2023 *

Parent/ Guardian 1 Name *

First

Last

Parent /Guardian 1 Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian 1 Phone Number *

Parent/Guardian 1 Email *

Emergency Contact Name and Numbers (other than parent listed) *

Allergies and Medical *

Chose all that apply: *

October 28 Fall Harvest Workshop December 15 Christmas Mini Camp Workshop

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