Registration
Is your child hurdling over the coffee table and playing spiderman in the hallway? We can help turn your child’s energy into ambition. We’ve got the perfect camp to focus on obstacle-course training, agility and balance – but most of all – we will have fun and your child will leave sweaty and smiling!
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
(Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Payment Agreement
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I've read the above and agree.
 
Release of Liability and Waiver Form
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I've read the above and agree.
 
Enter your Full Name: *   
 
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:*