Updated Student Registration Form

1Registration Options

2Student Info

3Parent Info

4Full-Time Enrollment Application

5Camp Registration

6Submit Registration

Select Registration Option(s)

Select for registration option(s) below:(Required)

Enroll your son in a 10X camp (i.e. Summer Camp, Mini-Camp)

Submit an application for your son to be considered for full-time enrollment

Select all that apply.

Student DOB(Required)

Student Age (Read-Only)

Auto-calculated based on student DOB

Please note, the age limit for 10X camps is 10-13 years old.

We typically require full-time 10X students to turn 11 years old BEFORE September 1st to enroll at 10X Academy. Please explain why you believe your son would qualify as a potential exception to this policy.(Required)

We typically require full-time 10X students to turn 14 years old AFTER September 1st to enroll at 10X Academy. Please explain why you believe your son would qualify as a potential exception to this policy.(Required)

How did you hear about 10X Academy?(Required)

Referred by friend/family

Postcard mailer

Facebook / Instagram

Google Search

Street Fair / Community Event

Previously Attended 10X Camp

Other

If referred by a friend/family, please share how THEY heard about 10X?

Please note the name or location of the Street Fair/Community Event

If OTHER, please note how your heard about 10X

Parent Information

Parent/Guardian Name(Required)

First Last

Relationship To Student

Parent (Mother)

Parent (Father)

Legal Guardian

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Enter Email Confirm Email

Parent's Home Address(Required)

Street Address City State ZIP Code

2nd Parent/Guardian Name

First Last

Relationship To Student

Parent (Mother)

Parent (Father)

Legal Guardian

2nd Parent/Guardian Phone

2nd Parent/Guardian Email

Enter Email Confirm Email

2nd Parent's Home Address(Required)

Street Address City State ZIP Code

Student Registration Form

Select Registration Option(s)

Student Info

Parent Information

10X Full-Time Enrollment Application

10X Camp Registration

Emergency Info

Camp Registration Fee

Registration Preview