Academy Registration

Student Information
Name:  
Age:   Grade:  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Payment Options
 Card Type
 Card Number #
 Expiration Date

 

 

Please make checks payable to:

On Deck

10229-A Rodney Blvd.

Pineville, NC 28134

 

To order by phone, call: (704) 889-2287

Upon receiving this form, On Deck will send an invoice or receipt to the email and/or address completed in the Contact Information section above.

 

Additional Comments

 

 

Events (please choose the desired event and session)
Contact Information
Parent's Names:  
Address:  
City:    Zip:  
Home Phone:  
Primary Email Address:  

 

 

 

 

 

 

 

 

 

Emergency Contact Information
Name
Home Phone Number
Cell Phone Number