Fusion @ Hampton Racquet – Registration Page

Student Information

Student Name
Birth Date
Home Address
Home Phone
Email Address
Parent 1 / Guardian
Work Phone
Cell Phone
Parent 2 / Guardian
Work Phone
Cell Phone
Emergency contact: (Name)

Credit Card Information

Credit Card
Expiration Date
Postal Code

Register for Weekly Program Below

Tuesday & Thursday  3pm – 5pm

Price per day $90 – Materials Fee Included = $180 Per Week


  • I hereby enroll the child named above and agree to ALL terms and conditions outlining the requirements of the FUSION Summer Program. Enrollment is for the time specified.
  • Leap Tutoring Academy reserves the right to dismiss any student whose behavior is disruptive to the day camp program. In such cases, there will be no refund.
  • I grant to Leap Tutoring Academy and to its employees the right to photograph my child and to use these photographs or video recordings for print or electronic publishing.
  • A fully completed medical form MUST be on file in the prior to the student’s first day. Both the parent section and the physician section must be completed. It will be provided to you upon registration.
  • No refunds for the program will be granted.

I have read the above statement, and the terms and conditions listed, and agree to all terms indicated.

By typing my name I agree to the above with my digital signature.