ROGY Registration Page Player Name * First Name Last Name Birthday MM/DD/YYYY ROGY Level Red, Orange, Green or Yellow Parent Name First Name Last Name Email * Parent Phone Number Emergency Contact and Phone Number Allergies/Medical Conditions * Credit/Debit Card Number CVV Number on Back Expiration Date Name As On Card By checking the box below, I authorize Rise Academy to charge the credit card or member number at this time and in the future as agreed to with Rise Academy and by this registration. I agree that I am the responsible party and in checking the box below, I agree to be responsible for and pay all fees associated with this program * I AGREE Thank you!! We have received your registration. Welcome to Rise!
