Online Registration

As we are registering students over the phone as well as in-person, we cannot guarantee that you will be able to get your desired class dates. Please refer to our online schedule OR call us to ensure your dates of choice are still available.

PRE-Registration Info

Full Name:
DOB:	Age:
Address:
City/St/ZIP:
Phone:	Alt Phone:
Email:
School:
Location:	Ada Location	Wyoming Location
Class:	Segment 1 ($100.00 deposit w/app, bal due 1st day) Segment 1 ($395 full payment) Segment 2 (Cost $75)	Segment 1 ($100.00 deposit w/app, bal due 1st day) Segment 1 ($350 full payment) Segment 2 (Cost $75)

Preference:	SEGMENT 1 Summer: Ada 9:00am - 11:00 am 12:00 pm - 2:00 pm 3:00 pm - 5:00 pm Wyoming 12:00 pm - 2:00 pm 7:00 pm - 9:00 pm School Year Classes: Ada 4:00 pm - 6:00 pm 6:30 pm - 8:30 pm Wyoming 7:00 pm - 9:00 pm	SEGMENT 2 Summer Classes: Ada 2:00 pm - 4:00 pm School Year Classes: Ada 5:00 pm - 7:00 pm Wyoming 9:00 am - 11:00 am 3:30 pm - 5:30 pm
Class Dates:

Billing Info

CC Name:
CC Type:	MasterCard / Visa / Discover / Debit
CC Num:	Exp: (mm/yyyy)
Card ID:	What's this?
Address:
City/St/ZIP:

Please make sure that the above information is correct BEFORE hitting SEND. The above information will be encrypted (rendered unreadable w/o a decryption key) BEFORE being sent to us. Your information IS secure. When you hit SEND, you will be taken to a confirmation page. The registrant will NOT be fully registered until we receive a form of payment.

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