Sign up for classes | The Rumpus Room

Class Name*

Class date(s):*

Number of people Enrolling*

One
Two
Three

$ Total Cost for all enrolling to this class*

Notes you want to share with instructor

First Student

Name: Participant 1*

First Last

Age: Participant 1*

Second Student

Name: Participant 2

First Last

Age: Participant 2

Age for 18 yo & under, otherwise put 'adult'

Third Student

Name: Participant 3

First Last

Age: Participant 3

Age for 18 yo & under, otherwise put 'adult'

Contact Information

Name of Parent or Guardian

First Last

For signing up anyone under 18 years old.

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Opt-in?

Would you like to get our email Newsletter? (Typically > 1 email month)

sure!
nope
I'm already subscribed!

May we use photo/video of you for future promotions?

yes
no thanks

Would you like us to share your contact info with other parents or class participants for carpooling purposes?

yes
no

Payment

Please mark your payment preference. Once you have completed and submitted this form, we will generate an invoice for Paypal or Credit card, or send you information about mailing a check.

How would you like to pay for your enrollment?*

Credit card (Includes +$2 convenience fee)
PayPal (Includes +$2 convenience fee)
Mail check
Bring it to class (returning students for weekly classes only)

Class and workshop enrollment

First Student

Second Student

Third Student

Contact Information

Opt-in?

Payment