Register for a program

Program Information

Location: The St. James - 6805 Industrial Rd - Springfield, VA 22151

Dates: Monday June 19 2023 - Thursday June 22 2023

Details: 6:15pm - 8:15pm

Group: Clinic: Group B: Ages 11 - Adult

Cost: $380.00

Admin Fee: $11.40

Total: $391.40

Waiver and Terms Acknowledgment

I have read and accept the Waiver

I have read and accept the Terms and Conditions

I have read and accept the Privacy Policy

Student Information

First Name

Last Name

Date of Birth

Gender

Primary Email Address

Secondary Email Address

Hockey Experience

Current Organization

Billing Information

First Name

Last Name

Address Line 1

Country

State

City

Postal Code

Main Contact Information

Copy billing name and primary email to main contact

First Name

Last Name

Email Address

Phone Number

Phone Number Type

Emergency Contact Information

Copy billing name and primary email to emergency contact

First Name

Last Name

Email Address

Phone Number

Phone Number Type

Survey

How did you find out about Pro Stride Skating?