WRTS Kids Gym Novi Summer Camp Pre-Registration

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

First NameLast Name
Child 1 Gender
Child 1 Birth Date

MonthDayYear
Child 1 Current School
Child 2 Name

First NameLast Name
Child 2 Gender
Child 2 Birth Date

MonthDayYear
Child 2 Current School
Which weeks are you interested in enrolling your child(ren)?
Which sessions are you interested in?
Which days are you interested in?
Have your child(ren) visited our gym before?
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.
Does your child currently have an IEP?
Does your child currently have a BIP?
Should be Empty:

Child Information