Teen Class Registration Form
Please complete for each student
Select Class(es)
*
Please select all of the followings:
*
I confirm that my child is at least 12 years of age and/or mature enough to participate.
I confirm that I informed my child about proper classroom etiquette.
My child will bring his/her own water and snacks.
Name of Child
*
First Name
Last Name
Name of Parent/Guardian
*
First Name
Last Name
Parent Email
*
example@example.com
Child's Contact Number (This will remain private and not be used for any marketing or shared for any purpose)
Please enter a valid phone number.
Parent Contact Number (This will remain private and not be used for any marketing or shared for any purpose)
*
Please enter a valid phone number
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number (This will remain private and not be used for any marketing or shared for any purpose)
*
Please enter a valid phone number
Submit
Should be Empty: