JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Soaring Kidz Program Registration: Taekwondo - Winter 2017
Sign in to Google
to save your progress.
Learn more
* Required
Child's Name
*
Your answer
Date Of Birth (mm/dd/yyyy)
*
Your answer
Age
*
Your answer
Registration Sport
*
Taekwondo
Soccer
T-ball
Basketball
Swimming
Gymnastics
Flag Football
Shirt Size
*
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Mother’s Name
Your answer
Father’s Name
Your answer
E-mail
*
Your answer
Primary Phone
*
Your answer
Secondary Phone
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Child Diagnosis
*
Your answer
Child’s Doctor
*
Your answer
Emergency Contact
*
Your answer
Emergency Phone
*
Your answer
Please read and respond to the following to help us serve your child better
*
(Check All That Apply)
My child follows directions consistently
My child is able to walk alone (even with a walker/gait trainer)
My child adjusts easily to new environments
Required
Please provide any helpful strategies for our staff to assist your child in adjusting:
Your answer
How does your child communicate?
*
Verbally
Signing
Non-Verbal
Communication Device
Required
Are there any other special considerations you would like us to know?
Your answer
Has there been any changes in your child’s medical condition or status since the previous program?
Your answer
MANDATORY PHYSICIAN RELEASE MUST BE COMPLETED AND RECEIVED BY SOARING KIDZ TO PARTICIPATE
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
