Registration Form

Student Details

Your First Name:

Your Last Name:

Relationship to student:

Discounts available with selected payment options.

Select Number of Students (Max. 4)

Student 1$154

Student 2$154

Student 3$154

Student 4$154

Select Program

Student 1

First name

Last name

Height

Special Needs/Consideration (If any)

Student 2

First Name

Last Name

Height

Special Needs/Consideration (If any)

Student 3

First Name

Last Name

Height

Special Needs/Consideration (If any)

Student 4

First Name

Last Name

Height

Special Needs/Consideration (If any)

Personal Details

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Alternate Phone

Receive Text Messages

Class Preferences

Park Locations

Preferred time of day

Preferred days

Payment Options

OPTION 1: Pay $149 cash at the first lesson

OPTION 2: Pay $145 per student thru your Venmo Account to @richard-hatch-76 ($4 discount). Please pay before the first lesson

OPTION 3: Pay $154 per student using Wix credit processing. You will be charged an additional electronic processing fee of $4.63 on your card.

Registration Form

Student Details

Personal Details

Class Preferences

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