Registration Form

Parent Details:

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail

example@example.com

Student(s) Details:

Student 1*

First NameAge

Student 2*

First NameAge

Student 3*

First NameAge

What class are you signing for?

Any medical conditions?

YesNoOther

If yes, specify what and who:

Terms & Conditions

LIABILITY NOTICE:D&L homeschool club, and its use of independent contractors, are not liable or
responsible for any accidental occurrences to the property of the students or the students itself
during service or while performing.As is the student not responsible for any accidental
occurrences to the persons orproperty of D&L homeschool Club and Independent instructor(s),
as well as their equipment/products. Any incidents occurred will start with immediate
communication from instructor to client.Instructor will do their best to resolve the issue at hand
in a timely and reasonable manner, but is not legally liable or required to meet any replacement of
said occurrence. Unfortunately we are not able to offer makeups or refunds for missed classes,
even if you know you will miss ahead of time.* Full payment is due upon sign up. Cancellations
made more than 14 days prior to start of session may receive a refund if the spot is able to be
filled. Cancellations made within 14 days of class start date are NONREFUNDABLE.

Signature

First NameLast Name