Registration Information

Student First Name *

Student Last Name *

Student Phone *

Student Grade *

---12th11th [+$25.00]10th [+$25.00]9th [+$25.00]

Guardian First Name *

Guardian Last Name *

Guardian Phone *

Guardian Email *

Guests

Select the # of guests you will be bringing.

---1 [+$50.00]2 [+$100.00]3 [+$150.00]4 [+$200.00]5 [+$250.00]6 [+$300.00]7 [+$350.00]

Dietary Needs/Requests

List the name of person and any dietary needs/requests.