Copy of QCPA 23-24 Registration Form

2023-2024 Season

Registration Fee:
$50 Returning Student
$75 New Student
1.Student's Name
2.Student's Date of Birth
3.Mailing Address
4.Primary Phone Number
5.Email Address
6.Parent/Guardian Name
7.Emergency Contact Name and Phone Number
8.Classes (Select Your Package or Desired Classes)(Required.)
9.Tshirt Size
10.Medical Concerns or Allergies?