Breathe & Learn at the Beach!

New Student Registration & Emergency Contact Form

Child's Name *
Child's Name
Please type the date or date(s) you plan to attend class with us:)
Parent Name *
Parent Name
Cell Phone *
Cell Phone
Name and Cell Phone.
I understand I must sign a waiver at drop-off. *
What is your total payment? *
Class packs may be split with friends and family.
How will you pay? *