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REGENT GYMNASTICS CLUB

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Gymnastics for All

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Registration form for Regent Gymnastics Club

Child Registration Form

First name*

Last name*

Date of Birth*

Month

Day

Year

Current Address*

Any medical conditions or injuries that we should be aware of*

Member *

Yes

No

If Yes, which class is the gymnast attending?*

If No, would you like to become a member and join Regent Gymnastics Club

Yes

No