Intermediate Fall 2026 Registration
Student First Name
*
Student Last Name
*
Birthday
*
Pick a date
Current School
Class Time - 1st choice
Class Time - 2nd choice
Parent First Name
*
Parent Last Name
*
Email
*
Phone Number
*
Address
How did you hear about us?
How would you like to pay?
Payment Info
*
Payment amount:
$135.00
Total to pay:
$135.00
Submit