Name *
Name
Phone *
Phone
Address
Address
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Section
Release: I, the undersigned do hereby release and discharge PPAC from any and all claims for personal injuries. By entering my name below I agree to this release statement.
Release Name *
Release Name
Agree to Use of Images *
I give permission to Presser PAC to use any photographs or media of student in promotional materials, commercials, and on the web site

Please send payment to 900 South Jefferson St., Mexico, MO 65265 

or visit our New Classes page to pay online.