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FOR OFFICE USE ONLY P/S 1_______2_______3_______ REC 1_______2_______ |
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FOR OFFICE USE ONLY |
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FULL PAYMENT MUST ACCOMPANY THIS FORM. ALL FEES ARE NON-REFUNDABLE. Registration may be done either by FAX 203-977-7898 with MC/VISA, or by mail with payment enclosed by check or MC/VISA sent to: ARENA GYMNASTICS—P.O. BOX 4665—STAMFORD CT 06907 |
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ADDITIONAL REQUIREMENT: Registration will not be accepted without full completion of the “Agreement” located on Registration Page 2. Please read, complete, and sign. BOTH PAGES MUST be in our hands prior to the start of class in order for your child to participate. Thank you. |
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Child’s Name____________________________________________M/F______
Age______Date of Birth________________Home Ph______________________
Address________________________________________________________
Cty_________________________________State_____Zip Code_____________
Full name of Parent/Guardian___________________________________________
Cell #___________________________ Work #___________________________
Email_______________________________________________________________
In emergency, call: (name)_______________________________________________
Hm #__________________________ Cl #_______________________________
Is there anything we should know about your child, medically or otherwise?
___________________________________________________________________
Class Desired: Day__________________________Time_____________________
_____Check or money order enclosed _____Please charge my credit card as below
MC/VISA ________________________________________________Exp. ________
Name of Cardholder___________________________________________________ |