Rehab Registration

REHAB REGISTRATION AND PAYMENT

Athlete Name

Athlete Birthdate

Athlete Club / School Team

Injury Overview

Parent / Legal Guardian Name

Parent / Legal Guardian Email

Parent / Legal Guardian Phone Number

Payment Type

Venmo (@fastfunctionalfeet) PayPal (fastfunctionalfeet@yahoo.com) Check Cash

1 individual session

$85

Advanced booking required. Session is valid for one year from the date of purchase.

8 individual sessions

$560

Advanced booking required. Sessions are valid for one year from the date of purchase.

12 individual sessions

$800

Advanced booking required. Sessions are valid for one year from the date of purchase.