GUYS LOCK IN REGISTRATION

Student Name *
Student Name
Student Phone *
Student Phone
Please enter parent/guardian phone number if student does not have one.
Address *
Address
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone *
Parent/Guardian Phone
Emergency Contact Name
Emergency Contact Name
(if different from parent/guardian)
Emergency Contact Phone
Emergency Contact Phone
(i.e. allergies, medications, medical conditions)
Liability Waiver *
Behavioral Policy *
Parent/Legal Guardian Signature *
Parent/Legal Guardian Signature
"By typing my name, I agree that I am the above age-18 legal guardian for this student and agree that I have read the above waiver/release form."