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Summer School Registration


Student Namerequired
First Name
Last Name
Must contain a date in M/D/YYYY format
Parent/Caregiver Namerequired
First Name
Last Name
Medical Treatment
I know that every effort will be made to contact me in the event of an emergency requiring medical attention for my child.  However, if I can’t be reached, I authorize program staff to call 911 to arrange for transport to the nearest hospital or medical facility and to secure necessary treatment. 

Payment Information

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Please select a payment typerequired
Billing Addressrequired
Cardholder Namerequired