Peoria Fashion Week Academy | Model Code Beginner Runway with Coach Ray
Register for Saturday beginner runway training—choose your class date and number of sessions, then complete required consent and contact details.
Student Information
Student Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
Student Email
example@example.com
Primary Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
Prior Runway Experience
*
None
Some
Guardian Information for Minors
Parent/Guardian Full Name
*
First Name
Middle Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Consent for Minor Participation
*
Class Selection and Preferences
Saturday Class Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Accessibility or Accommodations
Emergency Contact Name
*
First Name
Middle Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Photo/Video Consent
*
Yes
No
Email Updates Opt-In
Yes, send me class updates and announcements
Class Quantity and Payment
Number of Classes
*
Total Amount
Payment
*
prev
next
( X )
Model Code Beginner Runway
$20 per class. Payment active only when Square integration is connected.
$20.00
$
20.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
ACH Bank Transfer
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
Register
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