Registration
Class Card - 5 Punches. Choose from classes on the calendar linked here: https://app.jackrabbitclass.com/eventcalendar.asp?orgID=546859 Or under Events in the Parent Portal
Event:
Start Date/Time: End Date/Time:
Fee per Family: 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)*
 
 
 
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:*
 
 
eCheck/Bank Draft:
Bank Name:
Bank Routing Number: (9-digit number)
Your Account Name: (Your name on your bank statement)
Your Account Type:   Account Number: