Student Registration Form

Student Registration Form

SWEET PAN CLASS REGISTRATION FORM

STUDENT YEAR:
- Full Name (CHILD 1)
  
  First NameMiddle NameLast Name
- Birth Date
  
  DayMonthYear
- Full Name (CHILD 2)
  
  First NameMiddle NameLast Name
- Birth Date
  
  DayMonthYear
- Full Name (CHILD 3)
  
  First NameMiddle NameLast Name
- Birth Date
  
  DayMonthYear
- Telephone Number
  Home or Work
- Mobile Number
- E-mail
- Present Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Name of person and number to contact in case of emergency 1:
  Parent/Guardian & Telephone number
- Relationship
  ex. Father, Mother, etc.
- Name of person and number to contact in case of emergency 2:
  Parent/Guardian & Telephone number
- Relationship
  ex. Father, Mother, etc.
- Address of person 2 to contact in case of emergency
- ILLNESS / ALLERGIES
  Write/ Type: "NONE" if Not Applicable
- Name of school you attend
- Other Extra curricular activities/ What days?
- Skills/Talents
- Other Skills/talents
- Shirt size
- Signature
- Should be Empty: