JHUMBLE Fall 2025 Registration Form

JHUMBLE Registration Fall 2025

JEDI HIP HOP TUMBLE with Michál Anna Carrillo at Living Light Studio
Student Information

Personal & Health & Contact
Name

First NameLast Name
Birth Date

MonthDayYear
Age (at time of classes)
Grade
T-shirt Size:

Youth SmallAdult SmaillYouth MediumAdult MediumYouth LargeAdult Large
List Any Allergies and Dietary Restrictions
Any Medical needs?
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Information

(All correspondence and and invoices will be sent to this person)
Name

First NameLast Name
Name

First NameLast Name
Email
example@example.com
Email
example@example.com
Mom Cell Phone if applicable

Area CodePhone Number
Dad Cell Phone if applicable

Area CodePhone Number
If not a parent, what is relationship? if applicable
Emergency Contacts and Authorized Pick Up Persons
Emergency Contacts and Authorized Pick Up Persons
In case of emergency and unavaliability of parent, do we have your permission to go to hospital if needed?
Program Tuition $240 (including shirt)

"Donations" can be made by check to Living Light Ministry, or venmo: @livinglighthawaii or cash in person first class. If you need a different arrangement, please reach out directly to Michál at: 808 987-4243
Payment Type

Check enclosedVenmoCash
Terms & Conditions

I agree to have my child regularly & promptly attend class, ready to learn, in proper attire and properly fed. If my child cannot attend I will text Michál. I agree to be a proactive part of upholding the JHUMBLE CREED for/with my child and self. :)
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

JHUMBLE Registration Fall 2025

Student Information

Parent / Guardian Information

Program Tuition $240 (including shirt)

Terms & Conditions