Registration Form - Physical Education Classes for Homeschoolers 2015

Physical Education Classes for Homeschoolers requires a registration fee. Your registration cannot be confirmed until your credit card information is processed or payment is received in the mail. Registration fees are not refundable after the registration deadline.

Exchanges/Changes to Registration
Please do not re-register when wanting to exchange or change your registration. All changes must be submitted by email to Shellie Arbogast or by phone at (937)766-7755. Please include name of registrant, organization name, contact information and your desired changes. We will be happy to help in any way that we are able.

Medical Release Form must be filled out for each child and brought with you on the first day of class.

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Cancel Registration and Return to Home School Physical Education Program

Note: Red * text indicates required fields

Registrant Information

First Name, Last Name *
Address Line 1 *
Address Line 2
City, State, Postal Code *
Country
Phone Number
[999-999-9999 x999]
*
Email Address *

Event Registration

Cost is $10 per participant or $20 per family
Please indicate the age(s) of your child(ren) below. This will help us determine the size of each class.
Number of 5 year olds
Number of 6-7 year olds
Number of 8-9 year olds
Number of 10-12 year olds
Total Attending
List children attending:
Each on a separate line
with the following format:
[Full name, age, birthday]

Payment Information

Total Amount: $