Here’s to a hilarious 2023…
Student Name
Age
Date Of Birth
Parent Name
Phone
Email
Secondary Contact
Preferred Rehearsal Day MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Allergies The Got Ya Back Staff Should Be Made Aware Of YesNo
Other Medical, Behvioral, Disability Information That Could Assist The Staff YesNo
In The Event Of Sudden Illness Or Accident, I Give Permission For Got Ya Back Staff To Seek Medical Assistance If Required YesNo
I Give Permission For Photographs To Be Taken Of My Child YesNo
I Have Read, Understand And Agree To: Health Information YesNo
Fee Structure YesNo
Username or email address *
Password *
Remember me Log in
Lost your password?