Swagger Class Multi-Child Enrollment Form

Swagger Class Registration Form

List Dietary Restrictions in the medical concerns section. Registration Fees are non-refundable
CHILD INFORMATION:
Child Name- Child 1*

First NameLast Name
Child Name- Child 2*

First NameLast Name
Birth Date Child 1*

MonthDayYear
Birth Date Child 2*

MonthDayYear
Grade Child 1*
Grade Child 2*
Name of School Child 1*
Name of School Child 2*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
MEDICAL INFORMATION

Child 1
Physician Name- Child 1

First NameLast Name
Physician Name- Child 2

First NameLast Name
Phone Number- Physician 1
Format: (000) 000-0000.
Phone Number- Physician 2
Format: (000) 000-0000.
Medical Concerns- Child 1
Medical Concerns- Child 2

My Products*

Swagger Class Registration

Multi-Child Registration Form

$70.00 Multi-Student 2 Maximum

Total

$0.00

Swagger Class Registration Form