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REHAB REGISTRATION AND PAYMENT

Athlete Name *

First

Last

Athlete Birthdate

Parent / Legal Guardian Name *

First

Last

Parent / Legal Guardian Email *

Parent / Legal Guardian Phone Number

Phone

1 individual session

$90

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

8 individual sessions

$640

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

12 individual sessions

$900

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