Registration Form

Registration Form

Student’s Name *

Age *

Date of Birth *

Grade *

School *

Parent’s Name *

Primary Phone *

Secondary Phone *

Receive Email Updates for GLOSS for Girls?

Yes

Email Address *

Mailing Address *

City *

State *

ZIP *

Emergency Contact *

Phone *

Person Responsible for Payment: *

Is there anything you would like us to know about this student

How did you hear about GLOSS for Girls Classes? *

Agree *

I have read and agree to the following:

GLOSS Session Fee is due at the time of registration to reserve space.
I understand there are no refunds or deductions to class fees
Class space availability is on a first-come, first-serve basis
Minimum class size is 10, maximum class size is 25
Timely pick-up and drop off is necessary for each session as courtesy to the host home.

Mail Registration Form and Payment (cash or check only made payable to Wendy Tacey)
GLOSS COURSE: 20521 - 64th Ave. SE Snohomish, WA. 98296

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