B.E.A.S.T. Program — Registration

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Primary parent email

Parent 1 / Guardian (primary contact)

Full name *

Relationship *

Contact number *

Emergency contact / Parent 2 (optional)

Full name

Relationship

Contact number

Email

Home address

Address *

Child 1

No photo

Add photo

Athlete's full name *

Date of birth *

Gender *

Training days *

Tuesday 7:00–8:00 pm$230Wednesday 7:00–8:00 pm — Advanced$350Friday 6:30–7:30 pm$230Walk-in / pay-as-you-go ($30 per session)

Trial session

New athlete? Pick one timeslot to try before enrolling.

Tuesday 7:00–8:00 pmTRIALWednesday 7:00–8:00 pm — AdvancedTRIALFriday 6:30–7:30 pmTRIAL

This session is provided on a trial basis. Should you decide not to continue with the program, no payment will be required. If you choose to continue training, payment for this session will be included as part of your term fee.

Known allergies

Current medications and dosage

Ambulance member

Fee for Child 1$0

Total fees

$0

Tue or Fri $230 · Wed Advanced $350 · Both Tue+Fri $460 · Sibling $220 each · 8–9 weeks/term.

Consent

I have read and agree to the Release of Liability, Assumption of Risk & Parent/Guardian Consent. *

I agree to the Media Consent (photos/video for promotion).