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
Little Movers (2-3Y)
Little Movers (3-4Y)
Session:
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