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:
Session:
Start Date:
End Date:
Times:
Days of the Week:
Package Cost:
$
Paid in Full Amount:
$
Paid in Full Discount:
$
1st Classroom Payment:
$
2nd Classroom Payment:
$
1st BTW Payment:
$
2nd BTW Payment:
$

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 leave this field blank)
(As it appears on student's birth certificate)
(optional)
(optional, Example "Jr." or "III" as it appears on birth certificate)

Primary Address Information

Secondary Address Information

(optional)
(recommended)
(recommended)
(mm/dd/yyyy)
Safeway's program is for teens under age 18
(optional)

Parent/Guardian Information

Parent/Guardian (required)

Additional Parent/Guardian (optional)