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SUMMER CAMP RHYTHMIC: Full day camp (for all Team ) $380 (by/before 7/24/2018) REG on/after WED 7/25/2018 is $400.00 *Full week camp (from Monday through Friday) Before and after care (n/a) **Athletes must bring their own lunch. **No regular practice during Rhythmic Camp weeks. All athletes will be prorated automatically.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Father
Grandparent
Guardian
Mother
Other
Parent
Self
Step Father
Step Mother
Home Phone:
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Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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Zip:
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Emergency Contact Info
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Last Name:
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Student Gender:
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Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School:
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Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
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7th grade
8th grade
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college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
:
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
:
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
:
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
:
Questions/Options:
CHILD'S NAME:
DATE OF BIRTH:
AGE:
PRIMARY PHONE NUMBER:
EMAIL ADDRESS:
FULL DAY (ALL TEAM OR PRE-TEAM ATHLETES) (9:30AM-4PM):
(checked=yes)
HALF DAY (9:30AM-12:30PM) - ONLY BEGINNERS OR PRE-TEAM ATHLETES:
(checked=yes)
I. IMMUNIZATION INFORMATION: I agree that my child is current on all immunizations.
Yes
No
BEFORE & AFTER CARE
Yes
No
HEALTH INSURANCE CARRIER:
Additional Information:
PAYMENT POLICY
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PAYMENT POLICY: Please read carefully THERE ARE NO REFUNDS AND NO CREDITS. In order to hold your child's spot, a 50% deposit is due on day of enrollment.
Cash, Check, Visa, Mastercard, Discover and Amex accepted. There is a $25.00 charge for returned checks and credit card declined.
After June 1: Fees/payments will not be transferred or refunded in any case.
I've read the above and agree.
MEDICAL RELEASE AGREEMENT AND PARENTAL CONSENT
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I UNDERSTAND THERE IS NO CREDITS OR REFUNDS.
STUDENT ARE EXPECTED TO CARRY THEIR OWN INSURANCE. THE ABOVE NAMED STUDENT HAS HAD A MEDICAL EXAMINATION WITHIN THE LAST TWELVE MONTHS AND IS CAPABLE OF PARTICIPATING IN THE SPORT OF GYMNASTICS. I AGREE TO COMPLETE A HEALTH HISTORY FORM.
WARNING BY THE VERY NATURE OF THE ACTIVITY, GYMNASTICS CARRIES A RIK F PHYSICAL INJURY. COACHES AND INSTRUCTORS OF GYMNASTICS WORLD ARE SAFETY CONSCIOUS AND FOLLOW APPROPRIATE SAFETY PROCEDURES. IN THE EVENT OF INJURY OR ILLNESS, EVERY EFFORT WILL BE MADE TO CONTACT THE PARENTS OR GUARDIAN. IF NECESSARY, I AUTHORIZE GYMNASTICS WORLD TO ADMINISTER FIRST AID AND/OR AUTHORIZE MEDICAL TREATMENT IS THIS BECOMES NECESSARY.
I've read the above and agree.
Enter your Full Name:
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Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
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OR
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