Registration form Rhapsody RG Fredericton 2023-2024- Little Movers

Rhapsody RG Fredericton Registration 2023-2024

Complete the form below to sign up for rhythmic gymnastics - registrations are on first come first served basis. ONE FORM REQUIRED FOR EACH CHILD
Participant name*

First NameLast Name
Birth Date*

DayMonthYear
Gender*
Medicare and expiry date*
Allergies/special needs*
Mother's name

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Father's name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Guardian's name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
WAIVER*

In consideration of acceptance of my child's registration, I agree that I will not hold "Rhapsody" Rhythmic Gymnastics, its staff and volunteers responsible for personal injuries, property loss or damage while involved in club activities. I will accept financial responsibility for the replacement cost of any club equipment lost, stolen or damaged while in my child's possession. I understand that my child may be photographed and videotaped during classes and other special events. I give permission to Rhapsody Rhythmic Gymnastics to publish my child’s name, picture and video in the newsletter, flyers, on the board, on the club’s web site, Facebook page and use it for any other publicity or professional purposes.
WAIVER*

In the event of an emergency, "Rhapsody" Rhythmic Gymnastics staff and/or volunteers will first attempt to notify parent/guardians. Should immediate medical attention be required, "Rhapsody" Rhythmic Gymnastics staff and/or volunteers may transport my child to emergency facility and/or administer first aid.
Little Movers (2-3Y)

TuesdayThursday
Little Movers (3-4Y)

TuesdayThursday
Session:*

4 weeks12 weeks
Start Date*

MonthDayYear
Method of payment*
Special comments:
How did you hear about us?*
Date*

MonthDayYear
Parent/Guardian signature*
For organization use only
Should be Empty:

Rhapsody RG Fredericton Registration 2023-2024