Name *

First Name

Last Name

Cell Phone Number *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone Number *

(###)

###

####

Do you have health concerns or injuries? *

Yes

No

Do you take any medications? *

Yes

No

T-Shirt Size *

XS

S

M

L

XL

I certify that my answers are true and complete to the best of my knowledge. *

I understand that: tuition must be paid in full two weeks prior to the start of training; refunds will be made up to two weeks prior to the start of training, minus processing fee of $200; there are no refunds for books or supplies received by the student; there are no refunds for training hours missed. I understand that: to graduate, a student must complete all requirements, including class participation, hands-on practice, written and oral assignments, and community service; 100% attendance is required, but if it is necessary to miss a class, extra credit opportunities are available; it is the student’s responsibility to avail him/herself of these opportunities; students are expected to arrive on time and stay until the conclusion of class; cancellation of classes due to weather may occur, in which case additional hours will be added toward the end of the program; to graduate, all financial commitments must be met.

I Agree