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Parent/Guardian First/Last Name
*
Address (Street, City, Zip)
*
Email
*
Phone
*
Athlete(s) First/Last Name
*
Athlete(s) Age
*
Preferred Days/Times (please provide a few options)
*
Athlete(s) Current Skills
*
Athlete(s) Skill Goals
*
Athlete(s) Medical Conditions
*
Desired Purchase
*
Single Lesson
Monthly Package
Pay Forward Package (3 months) *includes two complementary lessons and free rentals
Requested Service
*
Private Lesson(s) - One Student
Semi-Private Lesson(s) - Two Students
Group Lesson(s) - Three Plus Students
Length of Lesson(s)
Thirty Minutes
Forty-Five Minutes
Sixty Minutes
Other
Frequency of Lesson(s)
Once a Week
Twice a Week
Other
Preferred Instructor
*
Coach Ivan
Coach Courtney
If preferred Instructor is not available are you okay with the other?
*
Yes
No
Will you be using your own equipment or renting equipment?
*
Own Equipment
Renting Equipment
Are you ok with video of athlete(s) for promotional purposes?
*
Yes
No
How did you hear about us? (if preferred by someone, please provide their first and last name)
*
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