RadioZindagiShowRegistrationForm | Young Champions

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Radio Zindagi Show - Registration Form

Child's Full Name

Child's Date of Birth

Mother's Name

Father's Name

Address

Primary Phone Number

Primary Email

Is child our Online student or in-person student? *

Online

In-person

Currently enrolled Class Time of the child (Pacific timezone)

Preferred Slot for Radio Show

Comments (optional)

Registration fee for this program is $25 per child per show

I am a current Young Champions customer and willing to enroll my child in Radio Zindagi's live radio show being organized by Young Champions. I agree that this is a non-refundable fee.

Thanks for submitting!

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