Hoop Stars Super Stars

Class Sign Up

Complete this form to register for the next session of our Super Stars program (for children ages 4 and up with special needs) If you have any questions, please contact Dan McKenna at hoopstarspa@gmail.com or call 201-400-4597

* Please note that a parent or guardian is required at all time throughout participation in this program

Contact Info

Parent/Guardian Name

First Name

Last Name

Email Address

Phone

(###)

###

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Child's Name

Child's Age

What is your child's special need/diagnosis?

Is there any medical/sensory information we should be aware of?

How did you hear about Super Stars?