Register

Registration Form

Please fill in all the required information and we will get back to you as soon as possible.

Student Name *

First

Last

Contact Phone Number *

Date of Birth *

Student DL# *

Issue Date *

Contact Email *

Address *

City *

Zip Code *

State *

Parent/Guardian Name *

Parent/Guardian Contact Number (if different)

Parent/Guardian Email Address *

Which class date do you plan on attending? *

• December 14th

Which class package would you like to sign up for?

• Beginner Basic - $320.00
• Beginner Plus - $360.00
• Beginner Premium - $400.00

Comments or Questions

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