Northern Lights Registration Form
Register your child for the 2024 Fall Season
Family Information
Parent/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Class Information
Number of Children
1
2
3
4
5
6
Child 1 Name
*
First Name
Last Name
Child 1 Grade
*
Child 1 Age
*
Child 1 Gender
*
Male
Female
Child 2 Name
*
First Name
Last Name
Child 2 Grade
*
Child 2 Age
*
Child 2 Gender
*
Male
Female
Child 3 Name
*
First Name
Last Name
Child 3 Grade
*
Child 3 Age
*
Child 3 Gender
*
Male
Female
Child 4 Name
*
First Name
Last Name
Child 4 Grade
*
Child 4 Age
*
Child 4 Gender
*
Male
Female
Child 5 Name
*
First Name
Last Name
Child 5 Grade
*
Child 5 Age
*
Child 5 Gender
*
Male
Female
Child 6 Name
*
First Name
Last Name
Child 6 Grade
*
Child 6 Age
*
Child 6 Gender
*
Male
Female
Payment Information
$50 is due today. You will receive an email within 1 week with a link to pay for the rest of the subscription.
Would you like to pay monthly or for the entire season?
Entire Season ($240 or $360 depending on grade)
Monthly ($80 or $120 depending on grade)
My Products
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$50 Deposit
The deposit will go towards your first bill. You will receive an email to pay based on your preferences above and any multi-child discounts that apply.
$
50.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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