Full Name (Parent/Guardian) *

First Name

Last Name

Second Parent/Guardian (Full Name)

First Name

Last Name

Phone *

Country

(###)

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Child's Age Group/Grade Level *

Provide us your child's age. There will be another registration form upon registering for classes. First come, first serve. If a class happens to be FULL, you will be added to our WAIT-LIST and notified via email about this as well.

Grade 1 (Age 6-7)

Grade 2 (Age 7-8)

Grade 3 (Age 7-8)

Grade 4 (Age 8-10)

Grade 5 (Age 9-11)

How Did You Hear About Us?

Please let us know how you learned about these summer classes? Thank you.

Kocurek Elementary Flyer

Word of Mouth

Other

Name *

First Name

Last Name