Little Bear Gym, LLC.
Registration Agreement 2010
 
Child’s Name: __________________________________ Birthday: _________________
Parent: __________________________________________________________________
Address: ________________________________________________________________
City: _______________________ State: ______ Zip Code: ____________

Home Phone Number: _______________ Office Phone Number: _________________

Email Address: _____________________

What is your child’s favorite song? __________________________________________
What is your child’s favorite game? __________________________________________

Please give us any additional information that will help us to meet your child’s needs:
_______________________________________________________________________

                               _______________________________________________________________________

_______________________________________________________________________

I Am Registering For:

 6 Month session: ____ 3 Month Session:____Flex Pass: ____

Special Class: ____   Non Member Session: ____  Free Trial:____
Birthday Party:____

Payment Enclosed: $_________



Signature: _____________________________ Date: _________________________

I agree to hold Little Bear Gym, LLC. and its instructors harmless for accidental injuries that may occur during play.
No refunds will be given after start of session.

Thank you for choosing Little Bear Gym,LLC, the best hour of the week!