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Athletes and Parents you do not want to miss this awesome workout! Yes Parents as well. Come workout like your kiddos do and see why they are in such good shape! You will leave sweating and feeling good!

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

	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

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:*