CGS Registration

Primary Contact *

First Name

Last Name

Phone *

(###)

###

####

Secondary Contact

First Name

Last Name

Secondary Phone

(###)

###

####

Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Primary Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

The student(s) live with: *

Both Parents

Father

Mother

Other (Please specify)

Please select the time that works best for you to attend. *

Wednesdays 5:15pm-6:30pm

Thursdays 9:15am-10:30am

Sundays (2 per month) 10:30am-11:45am

Student 1 *

First Name

Last Name

Date of Birth 1 *

MM

DD

YYYY

Student 2

First Name

Last Name

Date of Birth 2

MM

DD

YYYY

Please read the above statement carefully and respond to our media release here. *

I agree

I disagree

Today's Date *

MM

DD

YYYY

Tuition Assistance

Tuition assistance & payment schedule are available upon request.

I would like tuition assistance or a payment schedule