Class Registration Form
Student Name
*
First Name
Last Name
Student Age
*
Please Select
4 ~ 6 Yrs
7 ~ 10 Yrs
11 ~ 12 Yrs
13 ~ 16 Yrs
Adult
How old is your child?
Parent's E-mail (or Adult Student)
*
example@example.com
Phone Number
*
Which session are you interested in?
*
Please Select
Monday 4:00-5:30 ($160)
Tuesday 4:00-5:30 ($160)
Wednesday 4:00-5:30 ($160)
Thursday 4:00-5:00 (4-6yrs) ($145)
Adult Class 10:30-12:00 ($180)
Friday 4:00-5:30 ($160)
Saturday 10:00-11:30 ($160)
Message
Save a Spot!
Should be Empty: