Registration Form

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ELITE KIDS FITNESS REGISTRATION FORM

ELITE KIDS FITNESS REGISTRATION FORM
Name __________________________________ Grade ___ Age _______
Parent Name ____________________________ Phone ______________
Address ________________________________ Zip ________________
E-mail Address ___________________________
Any medical/behavior conditions we should be aware of? ______________
_____________________________________________________________
Allergies______________________________________________________
Does you child take any medications? If yes, what type? _______________
IN CASE OF EMERGENCY, CONTACT:
Name ____________________________ Phone ____________________
Alternate Name ____________________ Phone ____________________
Doctor ___________________________ Phone _____________________
Dentist ___________________________ Phone _____________________
PROGRAM NAME: (ex. Summer Beach Boot Camp)
Session____________________________ Dates ______________________
Session____________________________ Dates_______________________
Session____________________________ Dates_______________________
Session____________________________Dates________________________

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