Off Main Cheer & Tumbling Registration Form ... - JAMSpiritSites.com

Off Main Cheer & Tumbling Registration Form 2017-2018 Child’s Name: _________________________________________________________

Street Address: ________________________________________________________

City: ________________________________ Zip Code:________________________

County: ______________________________________________________________

School: __________________________

Birth Date: ___/____/____

2017-2018 Grade:_________________

Phone Number: ___________________________

Medical Conditions/Allergies: _____________________________________________

Insurance Carrier: ____________________

Policy #: ________________________

Carrier’s Phone: _______________________ Group #: ________________________

Parent Name: __________________________ Cell: __________________________

Email: ________________________________________________________________

Emergency Contact and Number: __________________________________________