Please fill out the form below. Please leave this field empty. Climber Information Name (required) Email Address (required) Phone Number (required) Member Status (required) Member Non-Member Select Day and Session Choose Day ---Sundays 2-4pmMondays 7-9pmWednesdays 7-9pm Please Select Start Date Sundays August 23 September 13 October 4 October 25 November 15 December 6 December 27 Mondays September 14 October 5 October 26 November 16 December 7 December 28 Wednesdays September 16 October 7 October 28 November 18 December 9 December 30 Payment Authorization (required) I authorize Chicago Athletic Clubs to charge my credit card on file I authorize payment to the credit card number listed below Credit Card Information (if applicable) I have a Groupon or discount code I would like to use, and will enter the number below. Please acknowledge cancellation policy below. I understand there are no cancellations or transfers after 1-week prior to start of class, and that there is a $20 fee for each make-up class. My electronic signature acknowledges that I verify all information on this form is accurate, and I have read and agree to the above policy. I understand my registration is not complete until confirmed by a CAC Climbing staff member.