|
Please
print clearly and mail the completed form with your check enclosed to: Fit
n Fun, 143 Via La Soledad,
Redondo Beach, CA 90277. Please make check
payable to Fit N Fun.
Participant’s Name & Age:
____________________________________________
Participant’s
School: ________________________________________________
Parent’s
Name & Address: ____________________________________________
City,
State and Zip: _________________________________________________
Email
Address: _____________________________________________________
Home
Phone No: ________________________ Work
No:___________________
Sports
Class: Soccer
@1 pm___ @3 pm___ T-Ball
____ Basketball
____
Day of the week: Tuesday ______ Wednesday______
Payment Method (Cash, Check, eCheck, Credit Card or Money Order):__________
Please
list any known medical conditions:________________________________
How
did you find out about our program?
From family or friend: ____
library, church or city park: ____
Preschool or Other
Sources: ____
Please name your
source: ________________________________________
Emergency
Contact Name:___________________________ Phone:___________
|