Teen Fight Class Registration

Please fill in the information below. * means information is required.

Password must be at least 7 characters long.
Name of Participant
Last Name of Participant
Street Address
Zip Code
Parent/Guardian Name
Parent/Guardian Primary Contact Number
Does the participant have any physical conditions that the instructors should know about? This is a very active course. If there are no concerns, please enter NO.
This is the name of someone who can be contacted if the Parent/Guardian cannot be reached.
Emergency Contact Number