Register your student

Parent's Name *
Parent's Name
Student's Name *
Student's Name
Phone *
Student's Birth Date *
Student's Birth Date
Address *
Does the student have any diagnosed disabilities? *
Does the student have any anxiety or behavioral problems? *

We will contact you when we receive your application. Your information is kept confidential. 
Payment of $125 application fee with later $250 registration fee to be paid when submitting all paperwork. The $125 is refundable if we are unable to serve the family.