Kids on Wheels Registration Form
Please fill in your infomation, print and mail it to Hyde Park Roller Magic
Last Name: |
Phone: |
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First Name: |
Cell: |
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Address: |
E-mail: |
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City: |
Parent/Guardian Name: |
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State: |
Session: |
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Zip: |
Session Time: |
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DOB: |
Office Use Only:
Deposit:
Cash:
Check:
M.O.
Date: Auth. Sig.:
*All Deposits are non-refundable and non-tranferable.
