FCA Registration - The King's Academy

Extracurricular Registration/Permission Form

FCA Tennis

Session Dates: (1-month sessions)

Teacher: Scott Williams swilliams@tka.net

Monday / Wednesday

Grades 6-12

Cost: $300.00 per month.

Time: 3:15 pm - 4:30 pm

Monday / Wednesday / Friday

Grades 6-12

Cost: $375.00 per month.

Time: 3:30 pm - 5:30 pm

*Beginners please attend Lions Tennis in November

Student Name:required

First Name

Last Name

Teacher Name:required

Grade:required

Parent Namerequired

First Name

Last Name

Contact Numberrequired

Parent Email Addressrequired

Name: Emergency Pick Up 1required

Name: Emergency Pick Up 2required

Medical/ Allergy/Injury Concerns:required

Terms of Servicerequired

I agree to the Terms of Service

I understand the following:

- Fees are not prorated due to absences, late registration, holidays, weather closings, or other after school activities.

- I am responsible to register and pay prior to my student attending the program.

- Students must be picked up at the designated end time.

- A non-refundable fee (per session or per semester) is required.

Payment Information

Emailrequired

Provide an email address for the receipt.

Please select a payment typerequired

Credit Card

Billing Addressrequired

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Namerequired

First

Last

Card Numberrequired

Expirationrequired

CVV Numberrequired