*1.Full Name of Parent/Guardian(Required.)

*2.Phone Number(Required.)

*3.Parent/Guardian Email(Required.)

*4.Full Name of Student(Required.)

*5.Student's Disability(Required.)

*6.Will your Student be attending with a support person?(Required.)

Yes

No

*7.May we contact you prior to open-enrollment for early bird registration?(Required.)

Yes

No

*8.Do you want to be updated periodically with news from the Extraordinary?(Required.)

Yes

No