*
Required
In The Middle @ Friends- November 11, 2023, 10:00- 11:45 AM
Parent 1 First Name
*
required
Parent 1 Last Name
*
required
Parent 1 Email
*
required
Home Phone (XXX-XXX-XXXX)
*
required
Address
*
required
City
*
required
State
*
required
Zip code
*
required
Parent 2 First Name
Parent 2 First Name
Parent 2 Email
Student Information:
Student 1 First Name
*
required
Student 1 Last Name
*
required
Gender
Please Select…
Female
Male
Non-binary
Student Date of Birth (MM/DD/YYYY)
*
required
Academic Year of Interest
*
required
Please Select…
2024-2025
2025-2026
2026-2027
Grade Applying to:
*
required
Please Select…
5th Grade
6th Grade
7th Grade
Student 2 First Name
Student 2 Last Name
Student Date of Birth (MM/DD/YYYY)
Academic Year of Interest
Please Select…
2022-2023
2023-2024
2024-2025
Grade Applying to:
Please Select…
5th Grade
6th Grade
7th Grade
Number of Attendees
*
required
How did you hear about this event?
*
required
Please send a confirmation email to the address below*: