Registration
2 openings left in this event!
Registration is not complete until payment is made. Please bring 2 healthy snacks and a lunch if your child does not want the one provided:)
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Relationship to Student
Home Phone: Cell #: Work #:
Email: (Emails are kept confidential)
 
Address: *
City: * State/Prov: * Postal Code: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
 
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:
Country:
City: State/Prov: Postal Code: