Registration
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Register for mini private lessons during camp. Lessons will be 20 minutes long with one of our amazing coaches.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Address Info
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student Age:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student Age:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student Age:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student Age:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student Age:
*
Questions/Options:
Additional Information:
Release of Liability
(Show-Hide Details)
I give my consent to my child named on this form to participate in the The Sophisticates, LTD.
I hereby for myself and executors WAIVE, RELEASE, AND DISCHARGE any and all rights for damages against The Sophisticates, LTD, their Director Andrea Whiting, or members for any and all injuries or damages suffered in connection to but not limited to practices, parades, exhibitions, competitions or any other activity or athletic participation with The Sophisticates, LTD.
I've read the above and agree.
Media Release
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I give my consent for my child to be photographed and/or videotaped during class. The pictures or video may be used on our website and print media to promote the activities offered by The Sophisticates, LTD. Please email twirlsophisticate@gmail.com if you have any concerns.
I've read the above and agree.
Payment Policy
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Payment is due at time of registraton and is non-refundable
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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