Registration

Register for classes using the online form:

"*" indicates required fields

Product Name

Choose Your Location*

Class Choices - Jackson Academy

Please select one

Number of Children Enrolling*

Child's Name*

Date of Birth*

Second Child's Name*

Second Child's Date of Birth*

Third Child's Name*

Third Child's Date of Birth*

Parent's Name*

Mobile Number*

Email*

Consent for Photos*

Yes

No

I grant permission for my child to be photographed for use in marketing materials such as brochures, posters, Ms. Kay’s Kids & Keys webpage and Facebook page.

Pay Monthly*

One Child

Two Children

Three Children

Your card will be charged this amount monthly. The $25 registration fee is included.

Total

Credit Card

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