The Goal Getter Club Registration
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child 1 Name
*
First Name
Last Name
Child 1 Birthdate
*
Child 1 Age
*
Child 1 Hopes, Goals, Dreams, Concerns
*
Child 2 Name
First Name
Last Name
Child 2 Birthdate
Child 2 Age
Child 2 Hopes, Goals, Dreams, Concerns
Select Private Lesson Date
*
Sept 20
Sept 22
Sept 27
Sept 29
First Choice Private Lesson Time
*
5:30
6:00
6:30
Choice of Private Lesson Location
*
My Location
Outside on Lower Common in Wakefield (1 Church St.)
Select Zoom Coaching Call Date
*
Sept 14
Sept 19
Sept 21
Sept 26
Sept 28
First Choice Zoom Time
4:00
4:30
5:00
7:30
Will you be joining us for Kid’s Night Out Sept 30th 5:30-9:30?
*
Yes
No
My Products
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Goal Getter Club Monthly Tuition
$
250.00
Quantity
0
1
2
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Name
*
First Name
Last Name
Submit
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