OPEN GYM Membership 2018-2019
First Name of Athlete *
Your answer
Last Name of Athlete *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Athlete Age *
Your answer
Parent/Carer Name *
Your answer
Relationship to Cheerleader *
Email of Parent *
Your answer
Address *
Your answer
Mobile Number of Parent *
Your answer
Home Phone Number
Your answer
Emergency Contact Number (If unable to get hold of parent) *
Your answer
School attended *
Your answer
Please list any health problems we need to be aware of. *
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