Young Teen Class – current 5th and 6th graders only (all genders)

Name of Young Teen *

Name and gender pronouns we should use in class

Names of other Young Teens you are registering

Name of parent or guardian *

Email *

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

Address *

City *

State *

Zip/Post Code *

Country * none selected Afghanistan Albania Algeria American Samoa Andorra Angola Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Côte D'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Costa Rica Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia Faroe Islands Fiji Finland France French Polynesia Gabon Gambia Georgia Germany Ghana Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar(Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Northern Ireland Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Réunion Sào Tomé And Príncipe Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu US Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wales Yemen Zambia Zimbabwe

Please let us know if your Young Teen has any particular or specific needs (allergies, learning disabilities, attention issues, injuries or medical conditions, or trauma history). If you feel more comfortable, you can call the office to talk it through. We cannot ensure that there will be sufficient time during drop-off at our first class to discuss these issues with instructors, so please let us know in advance so we can offer any accommodations that will support your child’s success in class.

How did you hear about us?

I agree to the Refund and Cancellation Policy below:

1. If cancellation is received more than two weeks before class is held, your payment is fully refundable.
2. If registration is canceled, for any reason, less than 2 weeks before class is held, your payment is non-refundable. a. You may re-register for a future class for half price, or, b. You may transfer your registration to another child for this class series. Please advise us of the new student's name and their family contact information so we can send a new confirmation letter.

We are unable to make any exceptions. If you have any questions, please contact us. *

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