Registration Form
Student Name
*
First Name
Last Name
Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Phone Number
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Please enter a valid phone number.
Parent/Guardian Email
*
Student's Current Age
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Please Select
10
11
12
13
14
15
Class Selection
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March 21-April 1, 2022 Cell Phone Permit Office
June 13th-18th, 2022 Cell Phone Permit Office
How Did You Hear About Us?
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Social Media
Friend/Family
Email
News
Creative Church
Other
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Terms of Service
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I understand that once this Cell Phone Permit registration is completed it is non-refundable. Should a class be canceled for health concerns, weather concerns, or any other reason, Cell Phone Permit will notify you and accommodate for make up classes as schedules allow. If you are tardy or absent from a scheduled class, you will need to make up the missed class to complete all class sessions before being able to receive your Cell Phone Permit.
I understand that the Cell Phone Permit instructors are mandated reporters. They are legally required to report any information with reasonable cause to believe that a minor known to the mandated reporter, in a professional official capacity, may be experiencing Abuse, Neglect, or Financial Exploitation. They do not have the burden of providing proof that abuse or neglect has occurred. Our instructors are here for the best interest of the students.
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General Registration
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147.00
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