Program Registration Form

Programs Registration
Are you registering more than one child?
Child Name *

First Name Last Name
Child 2 Name

First Name Last Name
Child 3 Name

First Name Last Name
Grade *
Child 2 Grade
Child 3 Grade
Child T-Shirt Size-(only for Teams Registration)
Child 2: T-Shirt Size-(only for Teams Registration)
Child 3: T-Shirt Size-(only for Teams Registration)
Parent Name *

First Name Last Name
Parent Cell Phone *

Area Code Phone Number
Your Child's Minecraft Name: *
Required to whitelist your child into our server.
Email (this email will be used to notify you re connecting via Zoom) *
example@example.com
Special Note

Payment Information *

Enter coupon

Total $ 0.00

Credit Card Information (we accept Visa, MasterCard, Discover, and Amex)
First Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Programs Registration