Fresh Heir Grooming & Dining Etiquette Program Registration Form

Fresh Heir Grooming & Dining Etiquette Program Registration

Empowering young men to master confidence, character and class; one lesson at a time.
Child Information
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Grade (as of next school year)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Fresh Heir Detroit during the selected session.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty: