Register

Class Registration

To register for classes, please fill out the following form, download and sign our Participation Waiver and either email a copy to stepsofgrace@aol.com or drop it off on the first day of class!

Participation Waiver

Child's name

First Name

Last Name

Birthday

YYYY

Gender

Male

Female

Age

t-shirt size

Parent/caregiver

First Name

Last Name

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

What is your child's diagnosis?

Does your child require assistance for mobility or balance? If so, please describe his/her needs.

Please describe any other special sensory, behavioral, medical, or other concerns we should be aware of.

How much assistance do you feel your child will need for optimal participation?

History of Seizures?

Yes

If you checked "yes" to History of Seizures, please indicate what we should do in the event your child has a seizure.

Allergies

If none, please put N/A

Please indicate the class for which you are registering

***Please see Class Schedule tab for descriptions of each class in order to choose the appropriate class for your child. Email stepsofgrace@aol.com if you have questions.***

If this is your first year, how did you hear about Steps of Grace?