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 Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Street Address Address Line 2 City State ZIP Code