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Winter Break Workshop Registration
Contact Information
Name of Parent/Guardian
*
First Name
Last Name
Email
*
Verify Email
*
Primary Phone
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Registrant Information
Name of Child
*
First Name
Last Name
Age of Child
*
Child's Grade Level
*
Please note, this workshop is intended for children in grades 1-6.
Payment Amount
*
$200
-
1 Child
$370
-
2 Siblings
$540
-
3 Siblings
$710
-
4 Siblings
Additional Children
Please provide the name(s) and age(s) of additional children to be registered.
Payment
Please note, your child's spot is not guaranteed until payment is complete. Make a secure online payment on the next page to confirm registration now. An automated receipt will be emailed to you.
