WIS Drop In Feb 7 Please enable JavaScript in your browser to complete this form.Participant Name *FirstLastParticipant Age **Must be age 18 and aboveParticipant Gender *FemalePlease provide us your e-mail *Do you Identify with a visible minority?YesNoPrefer not answerFor understanding and research purposes, we’re collecting information about racial and ethnic backgrounds. Would you feel comfortable sharing yours?What is your shirt size? *SMLXLXXLFor a reversible women's jersey. Please contact for additional size options. Must register for four drop in classes totaling $60 to be eligible to receive jersey. Will any children (ages 3-12) be attending with you? *YesNoIf yes, please list first and last name and age of each child attendingEmergency Contact Name *FirstLastEmergency Contact Phone *Emergency Contact Relationship *Program CostPrice: $ 15.00Total Amount$ 0.00Payment MethodPlease email payment to christina@wbsportconnection.com or use the Square link below. SquareCardName on CardPlease complete our waiver online using the link below *CompletedUnable to CompleteCopy and paste the following link in your browser: https://www.jotform.com/form/242616040793051 Please identify any health/general program concerns we should be aware of.Submit
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