ILM Academy Registration

Student's Full Name *

Student's Age *

Grade *Please select an option---12345678

Parent's E-mail *

Parent's Phone Number *

Playing Level *Please select an option---Beginner/NoviceBeginner-IntermediateIntermediateAdvanced

Select Your Payment Amount *Please select an option---$225 (Fall Session)$425 (with sibling / referral discount - Fall Session)

Sibling Name

Sibling Age

Sibling GradeSibling Grade---12345678

Playing LevelPlaying Level---Beginner/NoviceBeginner-IntermediateIntermediateAdvanced

Additional Comments

Liability Statement *

Yes, I agree with the privacy policy and terms and conditions.

Parent's Signature *Your Full Name

Mode of PaymentPaypalZelle

Submit