Registration

Registration Form

Please enter first and last name.
Enter street address, apartment if applicable, city, and zip code.
If applicable.
Please enter first and last name.
Please enter first and last name.
Please enter first and last name of individual other than parents or guardians.
Please state if the student has any medical conditions. Otherwise, enter N/A.
Please state if the student has any food allergies. Otherwise, enter N/A.
Please state if the student has an IEP (Individualized Education Program). Otherwise, enter N/A.
Is your child allowed to go out alone? (Chang Learning is not responsible for your child's saftey outside of our premises)
Please note all students in grades 7 - 12 will walk out of Chang Learning by themselves
Please enter first and last name of individuals other than parents or guardians authorized to pick up your child.
Do you give permission to Chang Learning to take photos of your child, which may be used on flyers, websites, posters, etc?
Select the program(s) that your child is registering for.
List any additional information about your child you would like to inform us about.
Please enter your initals
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