The ReFresh Institute, Inc.
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General Registration Form
Thank You for your interest in The ReFresh Institute, Inc./ ReFresh Global! We are happy to serve you! Please complete the registration form below.
There is a $50 non-refundable registration fee
(due at registration)
for all programming.
Thank you!
*
Indicates required field
Name
*
First
Last
Date of Birth
*
Gender
*
Male
Female
Age
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Program Interest
*
Beginners Piano
Drums/Percussion
Dance (Jazz, Hip-Hop, Contemporary & etc.)
Creative Writing
Please check all that apply
Level of Experience
*
Beginner ( 0 - 2 yrs Experience)
Intermediate ( 3-5 yrs Experience)
Advanced (5+ yrs Experience)
Church/Ministry Affiliation (if applicable)
*
Please provide your church or ministry affiliation's name and Leaders name
How did you hear about us??
*
Website
Social Media
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Facebook
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Lindkin
Friend Referral
Emergency Contact
*
In case of an emergency, please list contact information ( name, phone number, relation) for up to 2 individuals.
By submitting this form, you acknowledge that you have examined and completed this application to the best of your knowledge. I understand that non-refundable registration fee is due at this time. This submission hereby acknowledges my understanding regarding the registration and that content presented in this registration form is accurate and true.
Submit Registration
Home
Our History & Vision
The ReFresh Institute
Meet our Faculty & Instructors
Course Catalog
TRI Scholastic Bulletin
Donation/Contributions
Scholar Support Services
ReFresh Global
>
ReFresh Evergreen Community Improvement Initiative
Store
Contact Us