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STUDENT REGISTRATION FORM

required for all courses

December 9, 2022



First  Name

First Name*

Last Name*

Phone*
First  Date of Birth*
First  Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
First  Signature*
Second Name

First Name*

Last Name*
Second Date of Birth*
Second Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Third Name

First Name*

Last Name*
Third Date of Birth*
Third Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Fourth Name

First Name*

Last Name*
Fourth Date of Birth*
Fourth Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Fifth Name

First Name*

Last Name*
Fifth Date of Birth*
Fifth Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Sixth Name

First Name*

Last Name*
Sixth Date of Birth*
Sixth Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Seventh Name

First Name*

Last Name*
Seventh Date of Birth*
Seventh Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Eighth Name

First Name*

Last Name*
Eighth Date of Birth*
Eighth Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Ninth Name

First Name*

Last Name*
Ninth Date of Birth*
Ninth Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Tenth Name

First Name*

Last Name*
Tenth Date of Birth*
Tenth Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Name

Phone Number
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Participant Info
COURSE*

ADDRESS

Street Address

Address Line 2

City

State

Zipcode
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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