Application Form Order Number Returning Enrollment/Application Form September 2016 – June 2017 The Source River Centre (formerly Bacardi plant) $15 registration fee – students returning from broken attendance of more than 2 months $10 registration – returning students enrolled in regular program (Sep – June & summer camp) First name * Middle Name Last name * Father's Name Email Address Mother's Name Email Address Home Phone Cell Phone Home Phone Cell Phone Emergency Contact: Name: * Relationship: * Cell: * Medical Are there an known medical conditions that the child has which may potentially require medical intervention: If yes, please, fill our Medical Form Medical condition * Yes No It is the new policy of the club that all parents must volunteer for at least one event, each season: Events * World Gymnastics Day (September 2017) “A Passion for Pink, Flips for the Cure, October 2016 Starry Nights (May 2017) Website Development Marketing & Promotions Donations for training & equipment By clicking the box below, you agree to our Terms and that you have read our Privacy Policy. Confirmation * I attest that all of the information provided above is accurate to the best of my knowledge and belief:
