Registration Form

**Any personal information sent to Bright Bodies is kept strictly confidential. We never send any personal information to third parties. Collection of all personal information is in compliance with HIPPA requirements.**

Child's Name

First Name

Last Name

Parent/Guardian's Name

First Name

Last Name

Child's Birthday

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

How did you hear about us?

Registration Form

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