Blaze Cheer Season 16 Evaluation Pre-Registration

1
Athlete Name
First Name
Last Name
2
Athlete BirthdayYour Athletes Birthday
Date
Year
Month
Day
3
Athlete Birth Year Only
4
Parent/Guardian Name
First Name
Last Name
5
Parent/Guardian Email
example@example.com
6
Parent/Guardian Cell Phone Number
Please enter a valid phone number.
7
New or Returning AthleteReturning means you completed Season 15
New
Returning
8
Are you a referral from another BCT athlete?
YESNO
9
Which athlete referred you to the program?
10
Choose Your Evaluation DateMonday- Thursday @ 630 PM Only
Date
Year
Month
Day
11
My Products
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My Bag
2
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Season 17 Private Evaluation
$85.00Edit
Back
Processing FeeProcessing Fee
$3.00Edit
Back
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
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