Up & Over Registration if paying with credit card

Student Information
Name*
First Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Date of Birth*
Gender*
- Male
- Female
Grade Level (2024 - 2025 School Year)*
Dieterary Needs/Allergies/Medical Restrictions
Parent/Guardian Information
Name*
Relationship to Student
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Up & Over Registration Fee - $170 (which includes a $75 non-refundable deposit)
- Up & Over Total Cost: $170
- Up & Over Deposit: $75 (non-refundable)
Up & Over Total
$0.00

Student Information