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    Childs First Name:

    Childs Last Name:

    Childs Age:

    Date of Birth:
    / /

    Address Line 1:

    Address Line 2:

    Postal Code:

    Your Email:

    Telephone (preferably mobile):

    Telephone (landline):

    Choose Class:



    Other information:
    Does your child have any medical conditions?

    Does your child have any previous gymnastics experience?

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