To register, please complete the form below.

Refund policy: Registrations that are cancelled less than 7 days prior to the class start date are subject to a cancellation fee of $25. Cancellations more than 7 days prior to the class start date, will be refunded in full less a $10 fee for credit card refund processing.

Student Information

* Indicates Required Field
(As it appears on student's birth certificate)
(As it appears on student's birth certificate. If no middle name, please type "none")
(As it appears on student's birth certificate)
(optional)
(optional, Example "Jr." or "III" as it appears on birth certificate)
(optional)
(optional)
(mm/dd/yyyy)
Safeway's program is for teens under age 18

Parent/Guardian Information

Parent/Guardian (required)

Additional Parent/Guardian (optional)

Class Information

Classroom Start Date:
Monday, October 9, 2017
Classroom End Date:
Monday, October 30, 2017
Classroom Time:
6:00 PM - 9:00 PM
Location:
Maple Grove Safeway Classroom

Payment Information



Billing Information

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