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Welcome to Arizona Dreams online Waiver and web Registration!
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Referral Information
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Family Information
Family Last Name
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Primary Phone
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Additional Info
Emergency Contact Info
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Contact #1
Contact #1 First Name
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Last Name
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Type
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Aunt
Dad
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Other
Parent
Self
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Step Mother
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How Can We Contact You?
Home Phone
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Portal Access (your email is your login)
Email
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Confirm Email
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Portal Account Password
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Contact #2
Contact #2 First Name
Last Name
Type
Aunt
Dad
Friend
Grandparent
Guardian
Mom
Other
Parent
Self
Step Father
Step Mother
Uncle
How can we contact you?
Home Phone
Work #
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Arizona Dreams Gymnastics Academy. Standard message and data rates apply. Reply STOP to opt out
Email
(Emails are kept confidential)
Confirm Email
Student #1
Student's First Name
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Last Name
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Student Gender
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Female
Male
Birth Date
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Additional Info
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Student #2
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Student's First Name
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Last Name
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Student Gender
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Female
Male
Birth Date
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Additional Info
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Student #3
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Student's First Name
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Last Name
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Student Gender
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Male
Birth Date
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Additional Info
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Student #4
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Student's First Name
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Last Name
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Student Gender
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Male
Birth Date
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Additional Info
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Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Student #5
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Student's First Name
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Last Name
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Student Gender
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Additional Info
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Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
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November 21, 2024
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