UNIVERSAL POWER CHEER
DEL RIO, TEXAS
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STUDENT INFORMATION: |
NAME_________________________________________________ AGE________ |
ADDRESS_________________________________DATE OF BIRTH_____________ |
CITY, STATE, ZIP______________________________________________________ |
NAME OF PARENT OR GUARDIAN_______________________________________ |
HOME PHONE_____________________ CELL
PHONE___________________ |
WORK PHONE_____________________ |
IN CASE OF AN EMERGENCY CONTANT (PLEASE PRINT) |
1) NAME_____________________________________________ |
RELATION TO STUDENT ______________________________ |
HOME PHONE_____________________ CELL
PHONE___________________ |
WORK PHONE_____________________ |
2) NAME_____________________________________________ |
RELATION TO STUDENT ______________________________ |
HOME PHONE_____________________ CELL
PHONE___________________ |
WORK PHONE_____________________ |