EmailMeForm
Winter 2023 Trimester 2 Registration Galloway
Trimester 2: January 9-February 27, 2023
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Parent Name
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First
Last
Parent Phone Number
*
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Your city
*
Parent Email
*
Student Name
*
First
Last
Date of Birth
*
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DD
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Student age as of January 9, 2023
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How will you be paying for this child?
*
Please select
ONLINE, trimester 2 ($275)
MAIL, trimester 2 ($275)
Other
• If you choose mail: The address will be emailed to you upon submission of this form.
• If you choose online: You will be taken to a payment page upon submission of this form.
Payments must be arranged PRIOR to the first class.
If other, please specify:
*
Will you also be registering any siblings?
*
Please select
Yes, one more
Yes, two more
Yes, three more
No
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Total
$0.00
