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Step 1 of 2: Add Participant Information
Please fill in the information for all of the participants that will be attending the selected classes in the cart.
*
Denotes required field
First Name:
*
Middle Name:
Last Name:
*
Address:
*
Address 2:
City:
*
State:
*
Outside US
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Viginia
Wisconsin
Wyoming
Zip:
*
Email:
Day Phone:
*
Night Phone:
Same as
Day
Home Phone:
*
Same as
Day
|
Night
Cell Phone:
*
Same as
Day
|
Night
Other Phone Numbers:
Phone #
Which # is this (e.g. Mom's work)
Special Needs
Describe Special Needs (Disability, Allergies, and Other Notes)
Other Info:
student
Gender:
*
Not Specified
Female
Male
Age Group:
*
Age 0-5
Grade K-5
Grade 6-8
Grade 9-12
Age 19-54
Age 55+
School Attending:
*
-- Select One --
Chilton Catholic
Chilton Public
Hilbert
Hilbert Catholic
Homeschooled
New Holstein
Other
Trinity Rantoul
Valders
Grade:
*
N/A
PRE-K
K
1
2
3
4
5
6
7
8
9
10
11
12
Birth Date:
*
Instrument:
Swimming Level:
Shirt Size:
--
YS
YM
YL
YXL
AS
AM
AL
XL
2XL
3XL
Short Size:
--
YS
YM
YL
YXL
AS
AM
AL
XL
2XL
3XL
Bus Transportation needed:
*
Yes
No
Pick-up Person (if other than the parent)
Pick-up Person's name:
Relationship to the student:
Email Preference:
Yes! I want to receive news and promotion updates
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