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Stepping Up Registration

Stepping Up

Stepping Up Registration

2025-2026 Stepping Up Registration Form
Country
Address Line 1 *
City *
State/Province *
Postal Code *
Do you give permission for Club 21 to share your name, email, and phone number with the program room parent?
Room parents will be coordinating opportunities for connection outside of class meetings.
Month
/
Day
/
Year
If child is currently not in school please put "n/a"
I will require Spanish translation
Club 21 Member?

Please let us know which class you would like to attend for the 2025-2026 Stepping Up. If this is your first time in Stepping Up and your child is 3yrs or younger, we suggest that you attend Early Intervention. Although parents, at times, want to work ahead, we have to keep our students with their age group for their Classroom time. Parents can attend the Parent portion, but the students have to remain in their class based on their age/grad in school. 

Class Assignment:
Stepping Up Payment Options
Classes run from August through May
Monthly Payment Plan Agreement
If you are requesting funding from your Regional Center, please check box:

If you are using Self Determination funds, please fill out this information:

According to your spending plan
Payment Option
Credit Card Information
Make this a monthly payment?
Make this a monthly payment?
Your total payment will be
Your credit balance will cover
Your credit card will be charged
Your bank account will be charged
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