High Performance: HP1 Fall Program

Student Information

Student Name

First Last

Emergency Contact

Emergency Phone

Student Birth Date

School

Medical Conditions

Parent Information

Parent/Guardian Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Email

Parent Phone

Photo Release

I give permission for my child to be photographed and for these photos to be used, if selected, for a range of educational and promotional purposes such as print publications, online publications, presentations, websites, and social media.

Yes
No

I understand that I must have a signed liability waiver on file in order to play*

Accept

Please print out the PDF file below labeled 'ICTP Release Form' and fill out/sign the waiver in order to complete registration. Completed forms can be turned in to the welcome center

Class Registration

The Fall Program is $15/hr played. Credit cards will be charged each Monday, for the previous weeks balance.

Name on Card*

Card Numbers*

Expiration Date*

CVV*

Email for receipt

High Performance: HP1 Fall Program

Fall HP1 Program

Student Information

Parent Information

Class Registration