Childs Name

Age

Gender Gender Male Female

Level Level Beginner Intermediate Advanced

First Name (on credit card)

Last Name (on credit card)

Credit Card #

Billing address on credit card

Expiration Date

City

State

Zip Code

Phone

Email Address

Parent or Guardian Contact Name

Parent or Guardian Email

Parent or Guardian Phone

MONDAY - FRIDAY

AUG 16TH - AUG 20TH AUG 16TH - AUG 20TH 9:30am - 4:00pm 11:00am - 5:30pm

AUG 23RD - AUG 27TH AUG 23RD - AUG 27TH 9:30am - 4:00pm 11:00am - 5:30pm

AUG 30TH - SEPT 3RD AUG 30TH - SEPT 3RD 9:30am - 12:30pm