Please complete the following information about your household

* REQUIRED DATA
Email Address (up to 50 chars)
Password (up to 50 chars)
Re-Type to Confirm
Head of Household Information
Name of Primary Guardian (First)
Name of Primary Guardian (Last)
Date of Birth (mm/dd/yyyy)
Gender
Mailing Address
Street Address if different
City
State/Province
Postal/Zip Code
Primary EMail Address
Re-Type to Confirm EMail Address
Alternate Email Address
Alternate Email Address
Alternate Email Address
Alternate Email Address
Home Phone w/ area code (xxx)xxx-xxxx
Work Phone w/ area code (xxx)xxx-xxxx
Cell Phone w/ area code (xxx)xxx-xxxx
Cell Phone Provider
Secondary Guardian Information
Check Here if No Spouse
Name of Secondary Guardian (First)
Name of Primary Guardian (Last)
Date of Birth (mm/dd/yyyy)
Gender
Grade your child will be in the Fall 2020 highest high school grade completed
Secondary Guardian Email Address
Alternate Email Address
Alternate Email Address
Alternate Email Address
Alternate Email Address
Use Same Address
Mailing Address
City
State/Province
Postal/Zip Code
Use Same Phone
Home Phone w/ area code (xxx)xxx-xxxx
Work Phone w/ area code (xxx)xxx-xxxx
Cell Phone w/ area code (xxx)xxx-xxxx
Cell Phone Provider
Emergency Contact Information
What are Emergency Contacts?

Two people (other than parents) we can contact and/or release your child to in an emergency if parents cannot be reached.6042
Name of Emergency Contact (First) Name of Emergency Contact (Last) Contact Phone w/ area code Contact Cell Phone w/ area code Contact Work Phone w/ area code Relationship

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Would you care to be contacted via Email by us?

Other Information
* REQUIRED DATA

After you click "Finish" you will be taken to the Family Member page to enter all family member information.

	Name of Emergency Contact (First)	Name of Emergency Contact (Last)	Contact Phone w/ area code	Contact Cell Phone w/ area code	Contact Work Phone w/ area code	Relationship
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