FLOW Pre-teen Class

FLOW pre-teen class is designed for kids 9-12 years old.  Each week consists of fun conversations combined with a variety of skill-building exercises to build confidence, promote a positive self-image, and manage anxiety.

To take advantage of this class, be sure to register your teen.

Registration Form

Youth's Information

Youth's Name *

First

Last

Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Age of teen/tween *91011121314151617

Gender *

• Male
• Female

Name of School

(If applicable)

Select Class day/time *Monday @ 6pm - teens 13+Wednesday @ 6:30pm - teens 13+Tuesday @ 1pm pre-teens - 9 - 12

Classes meet each week (unless otherwise noted) for aproximately 90 minutes.

How did you hear about FLOW? *

Social media, friend, advertisement, other

Parent/Guardian Information

Parent Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Future Leaders Of the World session *

• One session(8 weeks) - $ 399.99
• Two sessions (16 weeks) - $ 749.00

Must register at least one week prior to the start of first class.

Emergency Contact

Name *

First

Last

Relationship to youth *

Cell Phone Number *

Does student have a prescribed an inhaler or required medicine? If yes, please explain any instructions.

Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is there any additional information we should know about your student to ensure a positive experience?

Informed Consent and Acknowledgement

Medical Release and Authorization

Disclaimer - Covid-19

Confirmation

Signature *

Clear Signature

Total amount due

$ 0.00

Submit