Enrollment Form:

CONOCOPHILLIPS GYMNASTICS CLUB

ENROLLMENT FORM

NAME
 (Please note male or Female)

AGE

BIRTHDATE

DAY AND TIME

OF CLASS

1.

 

 

 

2.

 

 

 

3.

 

 

 

4.

 

 

 

 

 

 

 

 

 

 

 

Mother’s name                                                                                       

Father’s name                                                           

Mother’s work phone                                                                              

Father’s work phone                                                                               

 Address                                                                                                                   

City                                                            State & Zip ___________________  

Home phone                                                                

Cell Phone #                                                                  

Email Address                                           

Recreation Card # _____________________ (or ConocoPhillips employee number)

 * Registration Fee   $______________ * Monthly Tuition $________________

 *Registration fee is non-refundable and must be paid at time of enrollment. Tuition is due at the beginning of the month and considered late after the 15th.  There is a $5.00 late fee per child if paid after the 15th.  Office hours 12:00p.m. to 8:00p.m.

                          PLEASE MAIL OR BRING ENROLLMENT FORM TO :

 CONOCOPHILLIPS GYMNASTICS CLUB

1805 S.W. ADAMS BLVD.

BARTLESVILLE, OK  74004

 661-8061