Registration Test Page

Registration Test Area

This page is for the purpose of testing the registration form.

REGISTRATION REQUEST FORM

Select a Class

Which class day do you prefer?

YOUR INFORMATION

Parent or Legal Guardian Name (required)

Street Address

City, State, Zipcode

Your Email Address (required)

Phone Number (required)

Alternate Phone Number

Text Number where we can contact you in the event that we need to cancel a class due to illness or weather

CAREGIVER'S INFORMATION

Caregiver's Name

Street Address

City, State, Zipcode

Telephone Number

Alternate Phone Number

Text Number where we can contact you in the event that we need to cancel a class due to illness or weather

Regular class communication (weekly emails, welcome to new quarter, etc.) should be sent to:

Parent / GuardianCaregiverBoth

Special communication (class cancellation, etc.) should be sent to:
Parent / GuardianCaregiverBoth

Payment is handled by:
Parent / GuardianCaregiverBoth

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CHILD'S INFORMATION

First Child's Name (required)

First Child's Age (required)

First Child's Birthday (required)

Second Child's Name

Second Child's Age

Second Child's Birthday

Third Child's Name

Third Child's Age

Third Child's Birthday

Additional Comments?

I have read and understand the class policy. Click here to read Class Policy

Please leave this field empty.