WRTS Kids Gym Novi Summer Camp Pre-Registration

WRTS Kids Gym Novi Summer Camp Pre-Registration
Child Information
Child 1 Name*

First NameLast Name
MaleFemale
Child 1 Birth Date*

MonthDayYear
Child 1 Current School*
Child 2 Name

First NameLast Name
MaleFemale
Child 2 Birth Date

MonthDayYear
Child 2 Current School
Week 1: 6/15-6/19Week 2: 6/22-6/26Week 3: 6/29-7/3Week 4: 7/6-7/10Week 5: 7/13-7/17Week 6: 7/20-7/24Week 7: 7/27-7/31Week 8: 8/3-8/7Week 9: 8/10-8/14Week 10: 8/17-8/21
Morning half day: 9am-12pmAfternoon half day: 12pm-3pmFull day: 9am-3pmEarly Drop-off: 8am-9amExtend hours
MondaysTuesdaysWednesdaysThursdaysFridays
YesNo
How did you hear about us? Who referred you?*
Parent/Emergency Contact Information
Name*

First NameLast Name
Relationship*
Cell Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your child verbal?*
Is your child potty trained?*
Does the child have any medical conditions and special requests? If yes, please describe.*
YesNo
YesNo
Should be Empty:

Child Information