Registration

Participant's Name:   (Please Print)

Age:           Male:         Female:

Address:   

City:

Postal Code:

Parent/Guardian Name:   (Please Print)

Phone Number:    Work Number:  

Emergency Contact:   

Phone Number:    

Email Address:    

Health Card #:     (Optional)

List Allergies:    

PROGRAM and LEVEL (Please check off the appropriate date(s))

Fall Session:   Cost:  $235          Winter Session:   Cost:  $235          March Break:   Cost:   $250

Summer Camp: Week 1: Week 2: Week 3: Week 4:       Cost:    $250

Advanced:                      Beginner: