Transcription of KPRegForm Submitted 02-27-03
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Example: bankruptcy
KPRegForm Submitted 02-27-03
REGISTRATION FORM PLEASE PRINT NEATLY! Registration Paid by: Cash/Check/Charge Date: _____ KidsPark Receipt # _____ First Name Initial First Name Initial Last Name (name used to identify your account) Last Name Home Phone Work Home Phone Work Cell Pager Cell Pager Address Address City State Zip City State Zip Driver License # Pass Word Relationship to Child/Children E-mail First Name Last Name First Name Initial Phone # Relationship to Child Last Name First Name Last Name Home Phone Work Phone # Relationship to Child Cell Pager First Name Last Name License # Phone # Relationship to Child Note.
ADMISSION FORM AGREEMENT On behalf of myself, my spouse, an d each child designated (my “Child”) I enter into this Admission Form Agreement (“Agreement”) with Swan Corporation, a Kansas Corporation, dba KidsPark, (hereinafter referred to as “KidsPark”), regarding the provision by KidsPark of a supervised, indoor play environment for my Child(ren)
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