Register For Friday Teen Capoeira

Choose Program

Fridays from September 8 - December 15, 2023 5:30-7:00pm

No class on the following Fridays:
September 22
November 10, 24

Contact Jarrel regarding payment upon registration.

415-350-2222. Jarrelp@gmail.com

Youth Applicant's Name (First and Last)

Parent/Guardian Name(s) (First and Last)

Youth Email Address

Parent/Guardian Email Address

Youth's Phone

Parent/Guardian Primary Phone

Address

City

State

Zip Code

Youth Applicant Age

Gender

Gender Identity

Ethnicity

Classroom number (if applicable)

Teacher's name (if applicable)

Does your child have any special needs?

i.e. food, allergies, mental health issues, behavorial concerns, etc

Allergies?

Does your child have any food allergies or dietary restrictions?

Please bring a signed liability waiver to the class. Click here to download it: Liability Waiver

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