Register for the Wonder Girls BERGEN | ROCKLAND 2023 - 2024 Program Name of Student * First Name Last Name Email of Student * Cell Phone of Student * (###) ### #### Name of Parent / Guardian * First Name Last Name Email of Parent / Guardian * Cell Phone of Parent / Guardian * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Grade * School * Do you have any allergies, health issues or take any medications that we should be aware of? * Emergency Contact * Please provide name and number. Choose payment option * Pay $15 monthly membership fee Pay $180 annual membership (receive 1 month free) Thank you for your application to our Wonder Girls program! Click here to pay for the annual membership in full.If you have any questions or concerns, please contact us at info@wondergirlsusa.orgThank you! THE WONDER GIRLS TEAM