Biz Kidz Registration Form
Virtual Sessions $65/Monthly - Homeschoolers $50/Monthly. Need to suggest a day & time? Please email us at info@bizkidz.us.
Please select your preferred session:
*
Mondays 4:00 pm - 5:00 pm EST
Tuesdays 5:30pm - 6:30 pm EST
Wednesdays 10:00am - 11:00am EST
Saturdays 9:30am - 10:30am EST
Parent/Guardian Information
Full Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Home Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Prefered Method of Contact?
*
Email
Text/Call
Mail
Relationship to Biz Kid?
*
Biz Kid Information
Full Name:
First Name
Last Name
Date of Birth:
*
-
Month
-
Day
Year
Please Select Your Method of Schooling:
*
Traditional
Homeschool
Business idea/interest:
*
Emergency Contact
Full Name:
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship to Biz Kid?
*
Payment
Please make sure your selection match above:
*
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( X )
Virtual
$
65.00
for each
month
Homeschool
Please note you will be required to show proof.
$
50.00
for each
month
Email
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Referral Information
How Did You Hear About Us?
Submit
Should be Empty: