SUSPENDED FORM

Enter Scholar Email

Enter Scholar First Name

Enter Scholar Last Name

Grade of scholar

Gender of scholar

Ethnic background of scholar

Enter school scholar is currently enrolled in

Select School district attended by your scholar?

Please select the answer that best applies to your scholar

How did you hear about us/this program/event?

Enter Parent/Guardian First Name

Enter Parent/Guardian Last Name

Enter Parent/Guardian Phone Number

Enter Parent/Guardian Email address

I agree to the collection and use of my child's personal information by Scholars Playground team.(This information is used to track scholar progress) (Please refer to the privacy policy on the Scholars Playground homepage for more details. The link will be on the bottom right corner of the homepage)