E7Fitness Registration Form
After School Fitness Program
Email address *
Select Center *
Salutation *
Full Name *
Your answer
Cell Phone Number *
Your answer
Alternate Phone/Email (if any)
Your answer
Full Address
Your answer
Childs Name *
Your answer
DOB / Age / M-F *
Your answer
Child Height (ft-in) Weight (kg) *
Your answer
Child School Name & Class
Your answer
Any Physical Activity/Sport currently played
Your answer
Guardian's Name and Number (if any)
Your answer
Child's Doctor's Name and Contact Details *
Your answer
Emergency Contact Person (name & number)
Your answer
Any Know Medical Condition/Allergies
Your answer
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