RH Extra Curricular Activities Form

Rising High Homeschool Academy

Extra Curricular Activities Form
Parents Full Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Alternate Phone Number *

Area Code Phone Number
E-mail *
Student Information
Full Name

First Name Last Name
Birth Date

Month Day Year
Name of School
Grade Level
Click to edit
Extra Curricular Activity
Select An Activity
Payment Details
Payment Mode *

Mail Reservation Fee of $50.00 Paypal
Paypal

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USD Extracurricular Activity
Signature

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Please remit a $50.00 registration fee that will be applied towards the fees for the selected class. Mail your fees to: Sondra Anderson, 4960 Hazelwood Drive, Alpharetta, GA 30004
For office use only
Registration Payment

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Payment Structure
Total (MYR)
Outstanding (MYR)
Payment Details
Should be Empty:

Rising High Homeschool Academy