Registration Form 

From Will Erase When Closed

Complete the the form and then print in landscape mode.

It can then be brought to gym,  faxed or scanned and emailed.

Form will not current email direct or copy and past to email.

Ron Price Personal Cell 205-937-1002

Fax  Coming Soon 

Complete form then Email To

ronald@ronaldprice.us

Please notify me by email of you interest and class times desired.

Child

Birthday/Age

Mother

Home/Cell #

Father

Home/Cell #

Address

Class/Fee

City

St/Zip

School

Referred By

Payment Circle Days Class Start Time Number of hours Monday - Thursday Choose Extra Practice Days Class fees
Information  MTWTh
Email

Auto Debt Payment Is Required  (Special Situations Are Defiantly Considered)
Account Information

Routing Number                          Account Number Number

 Expiration          Optional

Charge Date Desired		 Charge Amount

        

             

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