Student Life at Excelsior Preparatory School

Club Registration

Please fill out the following form to sign your student up for clubs.


  1. Student's Name*
    Student's full name is required
  2. Teacher's Name*
    Invalid Input
  3. 2018-19 Grade Level*

    Invalid Input
  4. Student's DOB*
    Invalid Input
  5. Parent's Name*
  6. Contact Number*
    Invalid Input
  7. Parent's Email*
    Please enter a valid email address
  8. Please check the box next to the club that you would like your child to be a member of for this academic year.

  9. Invalid Input
  10. I am also aware that students may be withdrawn from a club at any time based on one or more of the following reasons: tardiness, poor behavior, poor grades, poor attendance, lack of participation, and lack of respect for the facilitator or other members. Excelsior Arts Preparatory School reserves the right to dis-enroll a student at any time for any reason listed or unlisted above.
  11. Parent's signature*
    Invalid Input
  12. Student Signature
    Invalid Input


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