Clone of TEST_AFTER CARE

PLEASE FILL OUT ONE FORM FOR EACH CHILD

Child's Name

First NameLast Name

Birth Date

MonthDayYear

Gender

Address

Street Address

Street Address 2

CityState / Province

Postal / Zip Code

Parent's Name

First NameLast Name

Parent Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

E-mail

example@example.com

Father's Name

First NameLast Name

Father's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

ALLERGIES/SPECIAL CONSIDERATIONS

SELECT THE MONTH YOU ARE REGISTERING FOR (can select multiple options)

SELECT THE SEPTEMBER DATE(S) YOU ARE REGISTERING FOR

MONDAY, SEPTEMBER 14- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

TUESDAY, SEPTEMBER 15- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

WEDNESDAY, SEPTEMBER 16- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

THURSDAY, SEPTEMBER 17- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

FRIDAY, SEPTEMBER 18- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

TUESDAY, SEPTEMBER 22- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

WEDNESDAY, SEPTEMBER 23- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

THURSDAY, SEPTEMBER 24- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

FRIDAY, SEPTEMBER 25- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

MONDAY, SEPTEMBER 28- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

TUESDAY, SEPTEMBER 29- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

WEDNESDAY, SEPTEMBER 30- Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

SELECT THE OCTOBER DATE(S) YOU ARE REGISTERING FOR

MONDAY, OCTOBER 5-Select the time(s) you need, USE COUPON CODES BELOW FOR MULTI-CLASS DISCOUNTS

COUPON CODES

If you selected more than one session, use code KIDZ5 for 5% off.

If you selected more than two sessions, use code KIDZ10 for 10% off.

If you have already registered on child, and this is an additional child, use code SIBLING20 for 20% off.

Enter COUPON CODE if applicable:

SUBTOTAL

COUPON DISCOUNT

PRE-TAX TOTAL

SALES TAX

TOTAL AMOUNT DUE

USDTotal Amount Due

Payment Methods

Credit Card

Apple Pay

*

Payment Methods