Registration Health Rizz Parent Registration Form Child’s Name: *Parent/Guardian Name: *Child’s Grade: *Email Address: *Cell Phone Number: *School Name: *(Helps us match your child to the right program location)Any Allergies or Dietary Restrictions We Should Know About?Photo & Video ConsentWe may take photos/videos during sessions for marketing or educational use. Faces will never be fully visible (cropped, blurred, or from angles).Yes, I consentNo, I declineAnything Else You’d Like Us to Know?Select *Select ServiceHealth Rizz - After School Program ($315)Health Rizz - Birthdays ($500 for 10 kids max.)Credit / Debit Card *Submit
