EmailMe Form - 2023-2024 Enrollment Application

District *

Name of School Attending *

Student Name *

First Last

Male/Female

Male

Female

Date of Birth *

MM / DD / YYYY

Student ID Number *

Address *

Street Address City State / Province / Region Postal / Zip Code

Phone *

### - ### - ####

Email *

Parent Name *

First Last

Grades K-6 Plan Options

School Time Coverage - Standard Plan - $35

School Time Coverage - Elite Plan - $50

24 Hour Coverage - Standard Plan - $75

24 Hour Coverage - Elite Plan - $100

Grade *

Grades 7-12 Plan Options
(School Time Coverage does not include any athletic participation. 24 hour Coverage includes athletics, but excludes high school football grades 9-12)

School Time Coverage - Standard Plan - $35

School Time Coverage - Elite Plan - $50

24 Hour Coverage - Standard Plan - $125

24 Hour Coverage - Elite Plan - $150

Optional Football Coverage Grades 9-12
(08/01/23 - 08/01/24)