* Required InformationPlease Read Waiver of Liability Web Page Before Filling Out Online Registration Form. Students Last Name * First Name Last Name First Name Middle Initial Address Address 1 Address 2 City State/Province Zip/Postal Code Country Home Phone (###) ### #### E-Mail Address Gender Students DOB Only applies if student is under the age of 18 Parents Full Name, Last, First, MI Parents Full Name, Last, First, MI Referred By: *REGISTERING FOR WHICH CLASS? ARE YOU USING A COUPON TODAY? General Comments &/or Coupon Description Section 2 Waiver of Liability Section Located Below the Registration Tab Waiver of Libility Section I have read and understand the Waiver of Liability Section (Print Name, & Date) Do you have any Physical Limitations, Special Needs, or Medical Conditions which we need to be made aware of for your safety? Y/N (Explain) Signature Thank you!
