Student Enrollment Form
Copiosa Program
Student(s) Information
Please select the days you would like your child(ren) to attend*
* enrollment options​:
- 1 day/week ($25/week)
- 2 days/week ($45/week)
- 3 days ($60/week)
**Price is for first child. Additional siblings receive a 10% discount.
Please select an intended start date:
Student(s) Address
Parent Address (if different from student)
Parent/Guardian Information
Dismissal Information (persons permitted to pick up student; include parent(s)/guardian(s))
Emergency Contact Information (parents/guardians are the first emergency contacts; any additional, list below)
Allergies & Medical Information
Physical Activity Restriction(s)
Once you have completed and submitted the Copiosa Student Registration Form, you will receive a confirmation email.

This is for free 2 week Copiosa Trial.

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