Spring Break Mini Camp Online Registration Form

ONLINE REGISTRATION FORM
SPRING BREAK MINI CAMP 2010

SAFE AND SECURE!

Please provide the following information to start your online registration for your child(ren) in the Spring Break Mini Camp!

Please note, we will not charge your card until we verify that the correct tuition was chosen. If there are any problems with your registration we will contact you, if not you can expect to see your tuition charged within 1-3 business days.

PLEASE PROVIDE CONTACT INFORMATION:

Complete Name of Parent or Guardian: (Required)

Street: (Required)

Apt/Suite:

City: (Required)

State: (Required)

Zip Code: (Required)

Home Phone: (Required)

E-mail: (Required)

Mother Work Number (plus extension if any):

Mother Pager/Cell:

Father Work Number (plus extension if any):

Father Pager/Cell:

EMERGENCY CONTACT
Complete Name:

Phone Number:

STUDENT SESSION SELECTION and TUITION:

STUDENT A

Complete Name:

Birth Date:

Session A (March 15 - 19) $295
Session B (March 29 - April 2) $295

STUDENT B

Complete Name:

Birth Date:

Session A (March 15 - 19) $245
Session B (March 29 - April 2) $245

Next page will ask for your payment information and verify your total ....

FALL CLASSES

SUMMER CAMP

EVENTS

FALL CLASSES

FALL CLASSES 16-WEEK CLASSES Movement Education Gymnastics Dance Kid's Fitness Adult Classes

SUMMER CAMP

EVENTS

FALL CLASSES

FALL CLASSES