To register, please complete the form below.

Note on student emails: Safeway must have an accurate student email address for all students registered for a Distance Learning session so we can email links to classes and related class material. Parent email addresses will be included on any email sent to the student.

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.

Distance Learning
Start Date:
Mon, Mar 20, 2023
End Date:
Monday, April 10, 2023
6:00 PM - 9:00 PM
Days of the Week:
Mon, Tue, Thu
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, Example "Jr." or "III" as it appears on birth certificate)

Primary Address Information

Secondary Address Information

Safeway's program is for teens under age 18

Parent/Guardian Information

Parent/Guardian (required)

Additional Parent/Guardian (optional)