Home Alone (virtual)
Fall 2024
Student name
*
First Name
Last Name
Current grade:
Please Select
4
5
6
7
8+
Parent/guardian name
*
First Name
Last Name
E-mail
*
Phone
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registration:
*
prev
next
( X )
Session 1 (October)
$
69.00
CAD
October 15 & 17th, 2024, 6:00-7:30PM
Session 2 (November)
$
69.00
CAD
November 4th & 6th, 2024, 6:00-7:30PM
Subtotal
$
0.00
CAD
Tax
$
0.00
CAD
Total
$
0.00
CAD
Credit Card
First Name
Last Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Expiration Year
By entering my (parent/guardian's) name in the box below, I confirm that I am aware that this purchase is final sale, and no refunds or credits will be issued for non-attendance.
*
Parent/guardian first & last name
Register
Should be Empty: