About Boating Safely Class Registration
NOTE: You must be at least 11 years old to take this class
Class Date *
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone *
Your answer
Email Address *
Your answer
Is the Student Under 17 Years of Age? *
If you answered yes, please enter the student's birthdate
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How did you hear about our class? *
How do you want to pay for the class *
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