Registration Form

All fields are Required please (except if only enrolling one child)

I am enrolling my child in:
Date of Class & Time:

Name:

Age:

Grade:

Birthday:

I am enrolling my 2nd child in:
Date of Class & Time:

Name:

Age:

Grade:

Birthday:

I am enrolling my 3rd child in:
Date of Class & Time:

Name:

Age:

Grade:

Birthday:

Address:

City, State & Zip:

Parent's Names:

Home Phone:no dashes

Cell #:no dashes

Email Address for Class Confirmation:

How did you hear about us?

What would you like your child/children to gain from this class?

List any dietary requirements, medical conditions, or current medicines your child/children is taking:

**You will be notified via email within 48 hours once registration form is complete. Space is limited, so complete this form and mail required registration fee as soon as possible.  Complete a separate form for each child.  Late registrations will be accepted, space permitting.  If cancellations are made prior to 5 days before start of specific class, you will receive a 50% refund of fee.  If you cancel class after 5 days prior to start of specific class, the fee is non-refundable.  Call Debbie Garvey at 407-488-6600 for additional information.

*Photographs may be taken and sent to the local papers.

 

YOU WILL BE REDIRECTED TO THE PAYMENT PAGE AFTER YOU SUBMIT YOUR REGISTRATION FORM.

Signature: Date: