YTP INV Fall/Winter/Spring – Bullis Pass Academy

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YTP INV Fall/Winter/Springadmin2022-07-05T12:19:33-04:00

Junior Program Registration for Young Tournament Players & Invitational Programs

On-line Registration for the Pass Academy at Bullis School

These programs are limited to those approved by Pass Academy Professional staff.
The 2022/23 session runs September 6^th through June 11^th.

Pass Academy 2022/23 Registration Form
BY APPROVAL ONLY
Student's Name*
First Last
Age*
Please enter a number from 8 to 18.
Parent Information
Parent's Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Parent's Email Address*
Enter Email Confirm Email
Parent's Phone*
Progam Information
Students must receive approval from our coaches to participate in the following programs. Once approved, participants are accepted on a first-come/first-served basis. In order to get the maximum benefit from the program, we suggest students attend multiple days per week.
Young Tournament Players Program
Young Tournament Players
Price:
YTP OPTIONS
- Tues 5 - 7 ($2500) YTP
- Thurs 5 - 7 ($2440) YTP
- Sat 3 - 5 ($2310) YTP
- Sun 3 - 5 ($2370) YTP
Invitational Progam
Pass Academy Invitational
Price:
INV OPTIONS
- Fri 7 - 9 ($2500) INV
- Sat 5 - 7 ($2310) INV
Total Fees
$0.00
Credit Card*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Medical Authorization & Release
Student Name*
First Last
Student Condition*
- By checking this box it is understood that the student is in overall good physical health. If your child has a physical condition that may limit or restrict participation in certain activities, a physician’s note granting permission to participate in such activities must be presented prior to the first class session.
Date of Medical Authorization*
MM slash DD slash YYYY

By dating above, in an emergency, when I/we cannot be contacted, I/we hereby authorize the staff of the Pass Academy to take my/our child to the emergency room of the nearest hospital. I/we authorize that hospital and its medical staff to provide treatment deemed necessary for the well-being of my/our child.
Date of Parent Release*
MM slash DD slash YYYY

By dating above, I agree to hold the Pass Academy and Bullis School harmless for injury or loss that may occur as a result of my participation in Pass Academy activities.
Cancellation Policy*
- By checking this box I accept the following policy. Cancel prior to 1st class: pay for 1 class. Cancel after 1st class: pay for 1 class plus $75 replacement fee. Plus credit card fees. Cancel after 2nd class: pay for 2 classes plus $100 replacement fee. No refunds after 3rd week. Medical reasons will be accepted with a doctor’s note.
Permission for Photo Use*
- Yes
- No
I give permission for photos of my child participating in Pass Academy s at Bullis programs to be taken and used for the Pass Academy Website and/or Facebook page. We understand that if students are identified, only their first names will be used.
Additional Information (optional)

Our Contacts

10601 Falls Road
Potomac, MD 20854
director@passacademybullis.com
passacademybullis.com

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