Participant 1 *

First Name

Last Name

Participant 2

First Name

Last Name

Date of Birth Participant 1 *

MM

DD

YYYY

Date of Birth Participant 2

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone *

(###)

###

####

Parent Name 1 *

First Name

Last Name

Parent Name 2

First Name

Last Name

Cell #1 *

(###)

###

####

Cell #2

(###)

###

####

I have read, agreed to and signed the Spartan Gymnastcs (Distrcit) participation consent form *

Consent

I have read, agreed to and signed the Spartan Gymnastics (District) participation consent form.

Date Signed

MM

DD

YYYY

Online Waiver:

Electronic Waiver Submitted