Vie Halo Minis Registration

Students Full Name

Parent Full Name

Parent Email

Parent Cell

Age of Student

Student Date of Birth

Month

Day

Year

Does the student have any physical, cognitive, or chronic conditions that we may need to know about? If yes, please explain.

Does student have any allergies? (food, medication, environmental)

Permission to administer basic first aid?

Yes

No

I agree to sign a waiver of liability, release, and indemnity agreement prior to our first practice session, for the student listed above.

I understand that the payment for the Halo Minis Program is $175 Monthly from August-March of 2025-2026 calendar year.

Vie Halo Mini's Program Registration