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Registration Form

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Email Address *
Password *
(at least 6 characters)
Contact Information
Name *
Alternate Email Address(es)
(separate multiple by commas or semi-colons)
Phone Number
Address
City
State/Zip
Program
Program *
Details
• Name: Performance Enhancement Program (2 Days T/Th x 8 Weeks)
• Schedule: Tue and Thu from Jun 18 to Aug 8, 2019
• Price: $450.00
Location
TOP Fitness
5 Stadium Drive
Nashua, NH 03062
Start Times
Weekdays *




Athlete
Athlete's Name *
DOB *
Primary Sport
Primary Position
School
Payment
Amount
$450.00  
Payment Plan
(payments are charged monthly on the same day as registration)
Promo Code
   
Payment Method
         
Directions
Please mail in check or submit on first day of class.
Name on Card *
Card Number *
Expiration Date *
Keep Credit Card on File
(payment plans require info to be saved on file for automatic monthly payments until the balance is paid in full)
   
Billing Address 
Address *
City *
State/Zip *
Optional
Comments
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Digital Signature:
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