Circus Holidaze Registration 2018-2019
Junior Gamma Phi Circus Registration 2018-2019
Participant's first name *
Your answer
Participant's last name *
Your answer
Grade level
1st Parent name *
Your answer
1st Parent email address
this email will be used to communicate Circus information
Your answer
2nd Parent name *
Your answer
2nd Parent email address
Only add this email if you want it to go to both addresses
Your answer
Participant's email address
Include if you want Circus information to come to this email
Your answer
Emergency contact name *
Your answer
Emergency Contact phone number *
Your answer
Please list any Medical concerns that we should be aware of
Your answer
I understand that the Circus Activity Fee must be paid by the first practice September 19th, 2018. Here is the link to the payment site - https://secure.touchnet.com/C20868_ustores/web/store_cat.jsp?STOREID=14&CATID=110&SINGLESTORE=true *
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