KIDS CLUB REGISTRATION FORM LIABILITY R ELEASE /M EDICAL I NFORMATION FAMILY I NFORMATION: 1. 2. 3. MAILING A DDRESS E MERGENCY C ONTACTAND PHONE ADULTS.

 

KIDSÕ CLUB 2010-2011 DATE FAMILY A registration fee of 58. 00 for the first child and 48. 00 for the second, or 110. 00 for three or more children is due upon enrollment in the extended care.

 

KIDS CLUB REGISTRATION FORM LIABILITY R ELEASE /M EDICAL I NFORMATION FAMILY I NFORMATION: 1. 2. 3. MAILING A DDRESS E MERGENCY C ONTACTAND PHONE ADULTS.

 

School level School Name School Gender Mobile E-mail Mobile E-mail Principal Phone Principal E-mail Sch level Sch Gender.

 

Newbury Elementary School Kids Club 978-463-9850 Registration GRADE _______ DAYS CHILD WILL ATTEND please circle Morning:.

 

School level School Name School Gender Mobile E-mail Mobile E-mail Principal Phone Principal E-mail Sch level Sch Gender.

 

2009 2010 Membership Form Today’s Date __________ PARTICIPANT INFORMATION: Name: name or nickname: FullName Birth date: _______________.

 

! Junior barons clubt-shirt ! official membershipcard ¥ 10 discount off barons merchandise ! Five 5 Free general admission tickets ¥five ticket vouchers.

 

2006 RitzyÕ s JoinRitzy픀s The COOLEST kids in town are wearing the RitzyÕs Tee Ð and theyÕre Step1 - Purchase any Kids Meal. Step2 - Fill out the information.

 

REGISTRATION FORM I hereby give permission for my child to participate in any and all activities at the Choice Kids Club located at 25 East Bank Street in Albion,.

 

! ! ! ,! ! ! ! ! !! -. ,! / -. ! !! ! ! , - ! , - ! !. / 0 ! 1 ! ! 2 3 !! -. ! !! ! ! , - ! , - ! !. / 0 ! 1 ! ! 2 3 !! -. ! !! ! ! , - ! , - ! !. / 0 ! 1 ! ! 2 3 !! !1 15 6 ! ! 44 , - ! !! ! ! , - ! !! 5 ! 444 5 ! ! ! 3 0 ! 7.

 

/ 0. / - / /.

 

JOIN THE COOLEST CLUB IN TOWN! FOR ONLY 25 MEMBERS RECEIVE: One FREE ticket voucher to all Kids Club Nights, Tuesday home games.

 

2: RG¶V 6XSHU HURHV July23rd-27th 9 a. m. ± noon and Celebration Sunday, July29th at 10a. m. OVER Child Information one form per child KLOG¶V 1DPH Date.

 

! ! ! ! ! ! ! , , - !. , /. 01 2 ! 3 3 4 5 5 , 67 8 9:; 3 3 ! 3 6 ! ! ! ! !. 01 2 ! 3 3 4 , 67 4 5 5 , 67 8 9:; 3 ! ! !.

 

AWANA Kids Club Wednesday Nights 6:30pm-8:00pm October—May At Bethlehem Church we begin our AWANA club meetings with an exciting interactive.

 

COSmo’s kids CLUB MEMBERSHIPS Child’s name: Parent/Guardian name: Street address: City: State: Zip code: Gender: M FAge:Birthday: T-shirt.

 

www. com Waterloo Grant Township Public Library 300 S Wayne St Waterloo, IN 46793 Tel. 260-837 4491 www. waterloo. lib. in. us.

 

13 13on2812 26 19nd, 3rd, 4thst.

 

OPTIONS TIME A 7:30am Ͳ6:00 pm B 8:30am Ͳ 4:30pm When School is on break call theYMCA School Break Club House “Not.

 

102 Iberia St, Padstow NSW2211 E - mail: padstowanglican optusnet. com. au Phone: 02 97736574 ´ 2 25 7 35, µ. , 6 /8 8th ² 10th October 2008, 9am ² 1 pm Daily KLOG·V 5HJLVWUDWLRQ RUP Please complete.

 

Please Print Legibly Name: Date of Birth ____ Address: City/State: ___ Zip: ____ Cell Phone: ___ XDUGLDQ¶ s Name: School.

 

, , -. Yes No If so, which one ! ,-. / 0 / 3 Cost - 30. 00/child cash or cheque made payable to Cornerstone Church For more information visit www. com To contact us, phone 604-462-1161 or email.

 

Parent Information Postal Phone Relationship to Participant: Member: YES NO Medical Information Heath Card Number: Medications or Emergency Phone Registration.

 

Kids Club KLOGUHQ¶V 0LQLVWU RI WKH 6W DWKDULQHV 8QLWHG 0HQQRQLWH KXUFK Oct. 6 ± Dec. 1 Jan. 12 ± March29 6:30pm ± 8:00pm Parent / Guardianname s : Address: ________ ______.

 

KIDS BELLY DANCE WORKSHOP Ͳ Name of child and age: Ͳ Name of parent: Ͳ email: Ͳ Tel : Ͳ Emergency contact and ph : Please mail this form.

 

Paavo Nurmi Marathon 2nd Annual KidsRace Sponsored by: HarmaÕs Lawn and Property Service, Aukee Chiropractic Ð Paul Hageman,DDS Hurley Midget.

 

RETURN YOUR REGISTRATION AND PAYMENTTO: FOR OFFICE USE ONLY: CITY OF McA LLEN PARKS RECREATION DEPT. RECEIPT _______________ _____ P. O. BOX220 CASH.

 

2009 Student International Student Staff Community Address in Port Elizabeth Current residential Address If you are not from Port Elizabeth NB: INFORMATON.

 

Summercroft School Parsonage Lane, Bishops Stortford, Hertfordshire, CM226BJ Email: Telephone: 01279 851998 Name of Child. Age in yrs. Name of Child.

 

Summercroft School Parsonage Lane, Bishops Stortford, Hertfordshire, CM226BJ Email: Telephone: 01279 851998. Age in yrs. Name of Child. Age in yrs. Name of Child.