Your SlideShare is downloading. ×
titile
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

titile

96

Published on

dedcription

dedcription

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
96
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. LANA’S GYMNASTICS CLUB, Inc. Registration Form STUDENT INFORMATION (PLEASE PRINT) LAST NAME FIRST NAMEBirth Date Age: Sex: School: _______________________ MONTH DAY YEARSerious Injuries If “Yes” Please describe: ________________________________________________Any disabilities If “Yes” Please describe: ________________________________________________Last medical exam: Results:__________________________________________________ MONTH DAY YEAR RESPONSIBLE PARTY INFORMATIONMother: Last Name First NameFather: Last Name First NameHome phone: - - Business phone: - -Address: Apt.City: State Zip -Emergency Contact: - - Name PhoneHow did you hear about Lana’s Gymnastics? Friends: _____________ Newspapers_____________ Flyers Sign Open House Camp Yellow PagePLEASE, DO NOT WRITE IN THIS BOXDay Attending: SUN MON TUE WED THU Program: PRSCL GB BB GP BT PTM TM ____ DNC TKWD MSCTime:Session : Rate : Discount: % Reason:

×