Participant Name:
Date of Birth (m/d/y):
Parents Name (If participant is a child):
Address:
City:   State:   Zip:
Work Phone:
Home Phone:

MasterCard  Visa

If you choose to pay by Visa or MasterCard submit the above information and then, please call our office at 520-2384 within 1 business day and we will confirm your registration when you give us your Visa/MasterCard number over the phone.

If you choose to pay by check or money order,  please  send the registration information with your payment,  within 3 business days,  to: District 11/Community Education Office, 1115 N. El Paso Street, Colorado Springs, Colorado 80903. Upon receipt of your payment, your registration will be reserved and you will receive confirmation by mail.