Registration
**If you are not a member and would like to take this workshop as a guest, please complete this registration form. Card information will be required, and we will run your card within a few business days as we process your registration. (NOTE: Siblings of someone who is current enrolled are considered as "guests," but they can still be added on through the portal or by calling the office.) **If you are registering someone who is currently enrolled, please register them through your AODA Portal or contact the office, as currently enrolled students receive a discount :) Since your card information is already saved with us, we will run that card within a few business days as we process your registration. **FEES ARE NON-REFUNDABLE. IF YOU NEED TO CANCEL, YOU WILL RECEIVE AN ACCOUNT CREDIT.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email: (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Would you like to receive emails about future events like this? *
How did you hear about this event? (For ex: Current member, family/friend, website, social media)*
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*