Course Registration Form

Register directly by using our online catalog.  Use the form below if you prefer to not register & pay online.  Once you click the submit button below, your request will be sent to our Customer Service Office who will call you within one business day to collect payment.

PARENT / GUARDIAN  INFORMATION:  
    Name:  
    Address:
Resident Non-Resident
    Main Phone: Cell Phone:  Work Phone: 
    Email Address:
   
EMERGENCY CONTACT:  

    Name:   Phone:   Relation:
    Name:   Phone:   Relation:

   
REGISTRATION 1:
    Name:      D.O.B.
    Gender:  Male   Female    Grade:     Allergies:   
    Program Name:    Program Start Date:
    Shirt Size: YS YM YL AS AM AL
 
REGISTRATION 2:  
    Name:     D.O.B.
    Gender: Male Female    Grade:     Allergies:  
    Program Name:    Program Start Date: 
    Shirt Size: YS YM YL AS AM AL
 
REGISTRATION 3:  
     Name:     D.O.B.
     Gender: Male Female    Grade:     Allergies:    
     Program Name:    Program Start Date:
     Shirt Size: YS YM YL AS AM AL
 

WAIVERS & TERMS:


  Yes   No 


  Yes   No 


  Yes   No 

By signing below, I the Parent/Guardian, acknowledge that I have read and agree to the terms and conditions listed above.

Signature: Date:

Notes:


Customer Service will call you to obtain payment information.