Issue link: http://read.uberflip.com/i/43439
CITY RATE CARD REGISTRATION FORM Parents Name_______________________________________________________ Address___________________________________City___________________State________Zip______ Participant's Name__________________________________Date of Birth___________Age__________ Phone (home)___________________(work)_______________(cell)______________ Emergency Phone______________E-mail___________________________________________ Activty # Class Title Session/Day City Rate# Total 1st choice ____________ ____________ ____________ ____________ ____________ 2nd choice ____________ ____________ ____________ ____________ ____________ Payment Type: Check______Money Order_______Visa_______Mastercard________Discover________ Card #_____________________________________Exp__________________ Signature______________________________________________________________________________ Parents Name_______________________________________________________ Address___________________________________City___________________State________Zip______ Participant's Name__________________________________Date of Birth___________Age__________ Phone (home)___________________(work)_______________(cell)______________ Emergency Phone______________E-mail___________________________________________ Activty # Class Title Session/Day City Rate# Total 1st choice ____________ ____________ ____________ ____________ ____________ 2nd choice ____________ ____________ ____________ ____________ ____________ Payment Type: Check______Money Order_______Visa_______Mastercard________Discover________ Card #_____________________________________Exp__________________ Signature______________________________________________________________________________ Parents Name_______________________________________________________ Address___________________________________City___________________State________Zip______ Participant's Name__________________________________Date of Birth___________Age__________ Phone (home)___________________(work)_______________(cell)______________ Emergency Phone______________E-mail___________________________________________ Activty # Class Title Session/Day City Rate# Total 1st choice ____________ ____________ ____________ ____________ ____________ 2nd choice ____________ ____________ ____________ ____________ ____________ Payment Type: Check______Money Order_______Visa_______Mastercard________Discover________ Card #_____________________________________Exp__________________ Signature______________________________________________________________________________ 38 Idaho Falls Parks & Recreation Guide