Schedule a Lesson Online

Please fill in all fields marked with a *
Full name *
Email Address *
Daytime Phone *
Evening Phone *
Cell Phone *
Emergency Contact Name and Number *
Lesson Type Requested*
Date and Time of Day *
How Many Sessions Would You Like*
Level*
Payment Method*
Additional Info*
I Hereby Agree * I authorize Coach V to charge my credit card through Paypal below, in full for all programs selected. I understand that there are no refunds or credits. Make-ups are not guaranteed - however, Coach V will try to accommodate a request. Make-ups must be completed within 90 days. Lessons paid may be transferred to another party if I am unable to particpate due to serious illness, injury, or relocation. Payment is due in full before or at the start of each lesson. Installments available only to families with multiple members enrolled in program/s: equal payments over number of months equal to the number of enrollees - i.e: 2 months for 2 members, 3 months for 3 members etc. In circumstances beyond Coach V's control (i.e Inclement weather, local/national crisis or other emergency) will not provide make-ups, refunds or credits.

Waiver: I understand and acknowledge the risks of injury that are inherent in any program involving physical activity, and as the enrollee, parent or guardian of the child registered herein, I hereby waive and release any and all rights and claims for damages I may have against, Coach V, and any sponsors and their respective representatives for any loss of property or for any and all injuries in connection with participation in this program. I do hereby give my consent to medical care, emergency or otherwise, inclusive of any necessary transportation, in the event of injury to myself/ my child or ward. I have no objection to photographs taken with the program being used in advertising or other media efforts