2018-19 LOTUS FENCING ACADEMY REGISTRATION FORM 

Name of Fencer *
Name of Fencer
Date of Birth
Date of Birth
Phone *
Phone
Full Address *
Full Address
Name of Guardian (if Fencer is <18 years old) *
Name of Guardian (if Fencer is <18 years old)
Address, if different from Fencer
Address, if different from Fencer
Phone *
Phone
http://
Signature of Fencer or Guardian, if Fencer is a minor.
Signature Date
Signature Date