Personal Information
Child's Name *
Age, Weight & Shirt Size *
Example: 12, 98 lbs, Medium
Date of Birth *
MM
/
DD
/
YYYY
School *
Phone *
Address *
Family Doctor
Allergies & Medical Conditions
Type None or N/A if not applicable
Parent / Guardian Full Name *
Parent / Guardian Phone *
Best Time To Contact *
Required
Parent / Guardian E-mail *
Emergency Contact *
Example: John Doe 555-555-5555
Notes *
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