ELevate Enrollment

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Please complete the form below

Section One
Parental Information
Name *
Name
Parental Guardian (1)
Phone *
Phone
Cell Phone of Parental Guardian (1)
Name
Name
Parental Guardian (2)
Phone
Phone
Cell Phone of Parental Guardian (2)
Address *
Address
Section TWO
Child Information
Child's Name *
Child's Name
Birthdate *
Birthdate
Section Three
Class Selection
Class Selection *
Please select each class your child will be enrolling in.
Section FOUR
Signature / Parent Consent
Signature *
Signature
Signature Date *
Signature Date