BABYLON REGISTRATION FORM
| Parents Name | ________________________________________________ |
| Child's Name | ________________________________________________ |
| D.O.B. | ________________________________________________ |
| Address | ________________________________________________ |
| City | ________________________________________________ |
| State | ________________________________________________ |
| Zip | ________________________________________________ |
| Phone(home) | ________________________________________________ |
| Phone(work) | ________________________________________________ |
| Cell Phone | ________________________________________________ |
| Class/Classes Desired | ________________________________________________ |
| Days & Time | ________________________________________________ |
| Member ____ | Non-Member ____ |