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After-School Enrichment Registration

* all fields required!
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Student's Name(s)
*
Student's Age(s)
*   Grade(s)  *
Student's Classroom/Teacher
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Parent Phone 1
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Parent Phone 2
*
Parent Email
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Parent/Guardian Authorized for Pick-up
*
Comments / Notes for Instructor


PLEASE SUBMIT PAYMENT TO SECURE A SPOT IN CLASS!
(Select Payment Method) *
Check  (make check payable to Monart and submit before class)
Credit Card  (enter card info below or call to pay over the phone)

Credit Card  (Visa,  Mastercard,  Discover  or  Amex)
Number #    Exp.    CVC
Billing Zipcode   Total (see flyer for cost)


Public School Enrichment Flyers
Private School Enrichment Flyers