Registration

Gym bambin

Tuesday from 9:00 am to 10:00 am starting April 15th, 2025

Location : Gym bambin 18 mois à 36 mois, Gym Richelieu
Total : $185.00
Number of Lessons : 9
Available Places : 1 / 10
Registration ends at : April 12th, 2025 at 11:59 pm

Activity Info
Développement des habiletés motrices et de découvrir ses capacités dans un endroit sécuritaire avec leur parent.

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Participant's first name :

Participant's last name :

Participant's gender :

Participant's date of birth :

Full name of person to contact in case of emergency (if parents cannot be reached) :

Telephone of the person to contact in case of emergency (if the parents are not reached) :

Health Insurance number :

Health Insurance Card Expiry :

Particular health conditions of the participant :

ADD
ADHD
ASD
Asperger syndrome
Asthma
Behavioural disorder
Breathing problem
Cardiac malformation
Cystic fibrosis
Diabetes
Dysphasia
Dyspraxia
Egg allergy
Epilepsy
Fish allergy
Food allergy
Hypoglycemia
Kiwi allergy
Language disorder
Latex allergy
Myopathy
Nephrotic syndrome
Peanut or nut allergy
Penicillin allergy
Seafood allergy
Tourette syndrome
Trisomy (adult required)
Visual impairment
Others (if applicable):

Maillot (filles seulement à partir de 4 ans et plus) :
Optional

Maillot de gymnastique obligatoire pour les gymnastes à partir de l'âge de 4 ans.

None
a - Je dois acheter le maillot du club Gym-Richelieu (obligatoire) — $50.00
b - J'ai déjà mon maillot du club Gym-Richelieu

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Gym bambin

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