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Registration
(21st CCLC / LEAP / RISE)
This registration form must be completed in its entirety. Incomplete forms will not be processed. Spots are limited. Students cannot attend prior to receiving an acceptance notice.
Please select your school:
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HES
MES
WGES
WPES
CMS
MAHS
Student's Last Name:
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Student's First Name:
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Student's Date of Birth:
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+
Student's ID (Lunch Number):
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Grade:
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K
1
2
3
4
5
6
7
8
9
10
11
12
IMPORTANT: Students cannot attend prior to receiving acceptance notice.
See additional requirements and policies at the end of this form.
Give us an idea of your interests! We will include workshops from all areas, but student schedules are created based on their preferences. You may choose more than one - up to three. Activities may change based on enrollment and staff availability.
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Academic
Art
Fine Arts
Sports
STEM
Wellness
Address Information
Address:
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City:
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State:
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Zip Code:
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Parent E-mail:
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