Registration Form

Date of Registration
(same as your Paypal payment):



Student Name:


DOB:


Address (Include City,
State and Zipcode):



Phone:


Parent Name:


Parent Email:


Email used for Paypal payment:


Grade:


Additional Notes:



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Need more help? See our links and our FAQ's.  
You may also contact the director:
954-649-2274  (Text only please)

aeidirector@gmail.com



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