GLOSS FOR GIRLS 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 No 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 If you are human, leave this field blank.