Midweek Group Lesson Request Form

DATE OF YOUR VISIT:	Date and timeToday
GROUP NAME:*	Enter the name of the group provided to you.
MIDWEEK NUMBER:	Enter the midweek number provided to you.
PARTICIPANTS * Maximum of 3 per form:	P1=Main contact/Participant P2=Additional Participant P3=Additional Participant
P1 FIRST & LAST NAME:*	Name of the person name who will be the main contact (P1) for this form.
P1 AGE:*
P2 FIRST & LAST NAME:
P2 AGE:
P3 FIRST & LAST NAME:
P3 AGE:
REQUESTS/COMMENTS:
P1 E-MAIL:*	Main contact.
P1 PHONE:*	()-First three digitsSecond three digitsLast four digits Main contact.
ABILITY:
P1:*
P2:
P3:
LESSON TIME (Lessons are 1 hour):*	**FIRST TIME ONLY AVAILABLE AT 10:30AM.