Summer Courses Registration Fee 2021 Student's Name* First Last Student Grade Level for 2021-2022 School Year* Freshman Sophomore Junior Senior Mother/Guardian's Name* First Last Father/Guardian's Name* First Last Parent Email Address* Student is registered for:* Introduction to Wellness: I have already paid the $100 deposit.Open to freshmen, sophomores, juniors and seniors(Course fee is $285, I have already paid $100 of this) | June 7-July 2 Required Summer Algebra Review - For incoming freshmen only(Course fee is $175) | July 12-23 Lifetime Sports(Course fee is $285) | June 2-29 Lifetime Sports: I have already paid the $100 deposit(Course fee is $285, I have already paid $100 of this) | June 2-29 Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
