Program Registration Form

Youth Program Registration

* Indicates required field

Participant Name *

First

Last

Parent/Guardian Name (if participant is under 18) *

First

Last

Email *

Phone Number *

Program Dates *

Do you require shoe rental? *

Yes No

Have you climbed at The Rock Garden before? *

Yes No

Would you like to be added to our mailing list to hear about upcoming classes and programs? *