WCP/BHCT Class Registration Form
Visit http://www.wcpbhct.org/take-classes for the current list of classes.

Need more information? Please contact us at 319.235.0367 or info@wcpbhct.org
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Participant's First Name *
Participant's Last Name *
Participant's Age *
Parent's Name
(if participant is 18 years old or younger)
Email address *
Phone *
include area code, ex. 319-235-0367
The phone number provided above is my *
Street address *
City *
State *
Zip *
Class Title *
Session Dates *
List any special accommodations or assistance you need in order to participate in this class
Is the participant a current season ticket "member"? *
Payment Arrangements (payment is due 1 week before class begins) *
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