ATO INC CLASS/CLUB/CAMP/CLINIC STUDENT REGISTRATION 
Days of the Week/Coach/Time of Session Vary Depending on Class Selection
Sign in to Google to save your progress. Learn more
Email *
Student Name *
Student DOB *
MM
/
DD
/
YYYY
Student Age *
Student Nick Name *
Student Email *
Student Cell/Text # *
Student Allergies, Medical Issues and/or Concerns *
Parent /Guardian Name *
Parent/Guardian Best # to Contact *
Parent/Guardian Email *
1ST Emergency Contact (Name/Relationship/Best Contact #) OTHER THAN YOURSELF *
2ND Emergency Contact (Name/Relationship/Best Contact #) OTHER THAN YOURSELF *
My student will like to enroll in the following: For a list of date/time of offered classes,  club, camp, clinic, pricing, teaching coach, syllabus or class description, click here or here! For after school program interest, you can review the holiday/break calendar by clicking here! (CHECK ALL THAT APPLY) *
Required
I understand that parts of the session may be recorded or photographed for marketing, advertising, and/or social media posts.  *
I understand that the registration fee (if not waived) and first month of classes need to be paid 2 business days prior to class.  If not paid prior to class, I will be billed the daily drop off rate per unpaid class.  PLEASE TYPE IN FULL NAME OF PARENT/GUARDIAN OR PERSON FINANCIALLY RESPONSIBLE FOR THIS ENROLLMENT TO DIGITALLY SIGN AND ACKNOWLEDGE THIS PAYMENT AGREEMENT.  I UNDERSTAND THAT A SEPARATE INVOICE WILL BE SENT TO EMAIL(S) LISTED ABOVE ONCE CLASS REGISTRATION/ENROLLMENT TOTAL COST IS CALCULATED WITHIN 2 BUSINESS DAYS OF REGISTRATION FORM SUBMISSION. *
Does this student have siblings in other Classes with us? List Sibling(s) Names: *
Please share anything else you think our Coaches need to know about your student for them to be successful in class. *
I understand that participation in class activities may involve certain risks, including but not limited to physical injury. By electronically signing (adding your full name) on this student registration form, I voluntarily assume all risks associated with participation in these activities and hereby release At The Outlet, Inc., its employees, agents, and volunteers from any and all liability for personal injury, property damage, or wrongful death arising from or related to participation in class activities. I also agree to indemnify and hold harmless At The Outlet, Inc. from any and all claims, demands, actions, or causes of action arising out of my participation in class activities. If student is under 18, type parent/guardian full name to electronically acknowledge and sign this waiver. If student is over 18, type student full name to electronically acknowledge and sign this waiver. THANKS!
 *
How did you hear about ATO INC? *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of At The Outlet, Inc. Report Abuse
Google Forms