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Registration
2021-2022
Registration Fee $30
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* Indicates required question
Email
*
Your email
Parent/Guardian Name:
*
Your answer
Cell Number
*
Your answer
Street Address:
*
Your answer
Apt#
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Students Full Name:
*
Your answer
Childs D/O/B
*
MM
/
DD
/
YYYY
Childs Shirt size
*
XS
S
M
L
XL
XXL
Required
How did you hear about 6 Step Before the Lord?
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone Number:
*
Your answer
Medical Insurance:
*
Your answer
Any Medical Issues
*
Your answer
Any Allergies
*
Your answer
Which session would you like to attend?
*
Breaker 1 beginner ages 6 and up Thursday @ 6:20pm
Breaker 2 intermediate ages 6 and up Thursday @ 7:10pm
Breaker 1 ages 4-up Fridays @ 5:20pm
Breaker 2 ages 6-up intermediate Fridays @ 7:10pm
Breaker 1 beginner ages 6 and up Saturday @ 9:50 am
Breaker 1 beginner ages 6 and up Saturday @ 10:40 am
Breaker 2 intermediate ages 6 and up Saturday @ 11:30 am
Breaker 2 intermediate ages 6 and up Saturday @ 12:20 pm
Battle Squad/Performance Team @ 1:10 pm
Required
Would you like to do both Studio & Zoom
*
Zoom
Live Studio Session
Both zoom and live studio
Required
Payment
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Monthly
Quarterly
Bi Yearly
Yearly
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