Homeschool Program Registration Form

Before you fill out the form below, please note that registering online does not reserve your spot unless payment of your keiki's first month's tuition is received within 24 hrs. prior to the first day of class.

Name of Homeschooled Keiki *
Name of Homeschooled Keiki
Date of Birth *
Date of Birth
Name of Parent or Legal Guardian *
Name of Parent or Legal Guardian
Phone *
Phone
Address *
Address
Kindly select the number of days that you'd like your child to be enrolled.
Kindly select the number of hours per day and corresponding times you're enrolling your keiki
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
Kindly specify if your keiki has any special needs or if he/she requires any accommodations
Please type your name below. It will be considered your digital signature.