Growth Link KACHIDOKI Register Form(guardian,adult)

registration step3

STEP2

Filling in the required details

■STEP2 Filling in the required details

・Press the [Confirm] button after completing the form, and check the confirmation page.
・Please proceed to [Payment of Member Registration Fee, 500 yen (exclusive of tax), and Receipt of Member Card] at the Growth Link Kachidoki service counter within one month after pre-registration has been completed.

≫ Member registration(kids)

Your Name[required]
【Last name】 【First name】
Kana reading
Date of birth[required]
year month day
Postal code[required]
  Example) 102-0054
Prefectures[required]
City[required]
Town and address[required]
Cell phone[required]
  Example) 123-456-7890
E-mail[required]

Example) visual_shock@florence.or.jp
E-mail(Confirmation)
[required]
How did you know Growth Link KACHIDOKI?


Other, please tell me how.

・ Mail magazine is delivered once a month.
・ Newsletter Subscription is required for membership registration.
・ If you don’t wish to subscribe from the second time, please send it described as "unsubscribe hope" to this form.

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