Registration

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	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:


Participant's preferred first name*
Participant's last name*
Participant's age*
T shirt size (unisex fit) Child XS, Child Sm, Child Md, Child Lg, Child XL, Adult Xs Adult Sm, Adult Md, Adult Lg, Adult XL*
Please list any food allergies
Have you participated in any Aerial Silk Classes Prior? Yes or No*
If you answered yes to above what is your current level of class or level of last class taken
If an Aerial Troupe member referred you please list their name here.

Additional Information:

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Enter your Full Name: