Open House Registration

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Parent First Name:

Parent Last Name:

Student First Name:

Student Last Name:

Email Address:

Phone Number:

Year of Interest:

Grade Student entering in September 2023:

Day or Overnight Program:

I would like to attend the Open House on
April 15, 2023 at the following time:

I am interested in learning about programs for:

Ages 6-10:

Ages 11-14:

Grades 9-12:

Other Specific Interests:

Referral Source or Name:

I would like to stay informed of future Open House events