KP's ACTORS GYM
1470 N.Van Ness Ave.
Fresno,CA.93705
www.kpactorsgym.com
Participant Information
First Name
Last Name
Sex
M
F
Birth Date
Grade
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Activity #
Fee ($)
First Name
Last Name
Sex
M
F
Birth Date
Grade
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Activity #
Fee ($)
First Name
Last Name
Sex
M
F
Birth Date
Grade
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Activity #
Fee ($)
Total Fees for all Participants:
Household / Adult Primary Contact
Relationship to Participants:
Self
Mother
Father
Guardian
Other
First Name
Last Name
Address 1
Address 2
City
State
Zip
Phone
Alternate Phone
Email Address
Check which date your are attending/signing up for?
June 20-24 Session A
June 20-24 Session B
June 27-July 1 Session A
June 27-July 1 Session B
August 1-6 Session A
August 1-6 Session B
*
Indicates Response Required
Report Abuse