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YTP INV Fall/Winter/Spring
admin
2024-06-25T13:15:40-04:00
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 2024/25 session runs September 3
rd
through June 13
th
.
Pass Academy 2024/25 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
Sat 3:30 - 5:30 ($2970) YTP
Sun 3:30 - 5:30 ($2890) YTP
Invitational Progam
Pass Academy Invitational
Price:
INV OPTIONS
Sat 5:30 - 7:30 ($2970) INV
Total Fees
$0.00
Credit Card
*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
Expiration Date
Security Code
Cardholder Name
Session
Fall, Winter, Spring: September 2023 - June 2024
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)
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