CrossFit HTF Autism Spectrum Class
Please complete this application for our Fall 2019 class.

You may reach Francis Choe of CrossFit HTF with any questions. He can be reached via email at info@crossfithtf.com and via phone at 808.465.4597.

Email address *
Applicant's First & Last Name *
Your answer
Applicant's Age (as of Sept. 7, 2019) *
Your answer
Applicant's Birthdate *
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Applicant's School & Grade *
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Applicant's Type of Classroom *
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Applicant's Diagnosis *
Your answer
Please list any health issues or medical conditions that may impact his/her participation in class or is exacerbated by exercise or physical activity. *
Your answer
Parent/Guardian First & Last Name *
Your answer
Parent/Guardian Email *
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Parent/Guardian Phone Number *
Your answer
Home Address *
Your answer
City, State, Zip *
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