D/S private group

Name *

Nickname of Young Teen/pronouns

*

Names of other Young Teens you are registering

Name of parent or guardian

*

Email *

Phone (###-###-####)

*

Address *

City/Town *

State/County *

Zip/Post Code *

Please let us know if your Young Teen has any particular or specific needs or issues we should be aware of to better support them in class (allergies, learning differences, concerns about class, etc.)

Check the box to certify that all registrants are currently in 6th or 7th grade *

Refund and Cancellation Policy. This registration fee is non-refundable and non-transferable. If your child cannot make class and you need to cancel before class one, you may transfer your registration to another child in 6th or 7th grade - please contact the office to accomplish this transfer.

I agree to the Refund and Cancellation Policy. *

Please take the time to read the Release of Liability form carefully. We are unable to make any changes. Check the box to state that you've read and agree to the terms and conditions.

I agree to Release of Liability. *

I consent to my submitted data being collected and stored as outlined by the site .