Online Registration

Student *
Student
Please enroll my student in e-piphany's *
Parent/Guardian *
Parent/Guardian
Parent/Guardian Phone *
Parent/Guardian Phone
Address *
Address
Photo/Video Permission *
I understand that e-piphany may take photographs or video images from time to time, and that these images and videos may be used for e-piphany promotional materials and other business uses including but not limited to: e-piphany website, literature, and Facebook page. I am guardian of the registrant am authorized to make legal and educational decisions for the registrant. I authorize e-piphany to take photographs or video images of the registrant. I agree to allow these images to be used for the above referenced purposes.
Tuition Agreement *
e-piphany tuition payments are due by the 1st of each month. If we do not receive you payment by the 1st, your child will NOT be taken to computer class that day (unless you have contacted e-piphany staff and made other arrangements). If you wish to discontinue, please do so in writing.