top of page

Your input has been received the fun will begin shortly

An error occurred. Check the Red Fields and Resubmit

Brill's Student Name: 

Child Attending: 

Parent/Guardian of
child Attending: 

Email Address: 

Phone Number: 

Address: 

The participant and "signer" of this agreement acknowledge that the center Brill's or any affiliate are not responsible for any injury and by this agreement the undersigned assumes all risks inherent and incidental to this type of sports activity as a condition of admission.

bottom of page