Individual Registration

Please enter information in the form below to process registration for event 2021 Summer Junior Academy - Academy Package.

Child's Name *

Age Division *

Age 7-9, Tuesday 4-5pm

Age 7-9. Wednesday 7-8pm

Age 10-12, Wednesday, 4-5pm

Age 10-12 Wednesday, 6-7pm

Age 13-17, Thursday 4-5pm

Age 13-17, Thursday 6-7pm

First Name *

Last Name *

Phone *

Email *

Amount

Payment Method

Credit Card via Paypal

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*