TUMBLE BEE GYMNASTICS AND FITNESS

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EMERSON REGISTRATION FORM

 

CHILD’S NAME _________________________________________________________

AGE___________

ADDRESS______________________________________________________________

PARENT’S NAME________________________________________________________

PHONE #_______________________________________________________________

E-mail_______________________________________

 

VISA__________MASTERCARD__________CASH__________CHECK___________

NUMBER_______________________________________________________________

EXP DATE__________

 

I am enrolling for 1st choice: DAY: _______________TIME: _______________

I am enrolling for 2nd choice: DAY: _______________TIME:

 

PLEASE READ AND SIGN:

I certify that the above named Enrollee has no condition that prohibits full participation in classes at Tumble Bee of Emerson.  I assume all ordinary risks when using the facilities and agree not to hold Tumble Bee of Emerson or any of it’s instructors or employees liable for injury or damage which may occur to me as a result of my participation in classes or related activities at Tumble Bee of Emerson. In case of accident, I give Tumble Bee of Emerson its agents and employees to contact, and if necessary, obtain needed medical attention for my child.  I understand and accept all enrollment conditions.

 

 

Signature: ______________________________________Date: ____________________

 

MAIL TO: TUMBLE BEE OF EMERSON, 465 Old Hook Rd., Emerson, NJ 07630

http://tumblebee2.tripod.com