Phoenix Academy - Winter 2018 - Registration Form

Please note that we only accept Visa, Mastercard, or Discover. Also, make sure cookies are enabled on your browser !


First Name:



Last Name:



Gender:


Street Address:


City:


State:


Zipcode:


Date of Birth:

Month

Day

Year


How Did You Hear About Us?




Parent 1 Name:



Email:


Cellphone:

Area Code

First 3 digits

Last 4 digits



Parent 2 Name:



Email:


Cellphone:

Area Code

First 3 digits

Last 4 digits



Payment:

Discount Code:

If you do not have a discount code, leave this blank



TEAMMATE REQUESTS

If your child wants to be on the same team as another player, please enter the request here. Requests can only occur for players of the same age group AND in the same package (advanced or standard).




By checking this box, I understand that I am paying membership dues for a child in this program. Membership dues are not transferable to other children or parents.

By checking this box, I understand that a child's membership can be terminated due to conduct deterimental to the program.

By checking this box, I understand that membership dues are nonrefundable after 96 hours of making an online payment and I have read the Payment and Privacy policy. There are no exceptions regardless of reason or circumstance. I futher understand that my child cannot participate in any activities if only a partial payment has been made by the payment deadline unless I am on an approved payment plan.

Click here to read our policy.

By checking this box, I agree to sign and submit a participation consent form.

Click here for the Consent Form





Please note that you will recieve two emails. The first email is a registration confirmation email. The second email is a payment confirmation email. If you do not recieve the second email, you are not properly registered.