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Summer Program Registration
Student Full Name
Grade in Sept 2021
Email
Phone
Parent/Legal Guardian Name
Street Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
Please list Preferred Days of Week and Subject Areas
4 Sessions Package ( 1 Session a Week)
8 Sessions Package (2 Sessions/Week)
12 Sessions Package (3 Session/Week)
REGISTER
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