Lawrence Gymnastics & Athletics Online Registration

Registration

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Welcome to LGA

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family last name Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Name and Phone #

Alternate Payment Person

Contact #1

Contact #1 First Name*

Last Name *

Parent/Guardian*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Parent/Guardian*

How can we contact you?

Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Your child's T-shirt size?

Ok to Photograph your child?*

Ok to Video your child?*

Request to drop student(s)

Please select the classes in which you wish to enroll in. Please note that the tuition will be posted but we will go in and correct it for pro rated/family discounts, if needed.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Your child's T-shirt size?

Ok to Photograph your child?*

Ok to Video your child?*

Request to drop student(s)

Please select the classes in which you wish to enroll in. Please note that the tuition will be posted but we will go in and correct it for pro rated/family discounts, if needed.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Your child's T-shirt size?

Ok to Photograph your child?*

Ok to Video your child?*

Request to drop student(s)

Please select the classes in which you wish to enroll in. Please note that the tuition will be posted but we will go in and correct it for pro rated/family discounts, if needed.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Your child's T-shirt size?

Ok to Photograph your child?*

Ok to Video your child?*

Request to drop student(s)

Please select the classes in which you wish to enroll in. Please note that the tuition will be posted but we will go in and correct it for pro rated/family discounts, if needed.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Your child's T-shirt size?

Ok to Photograph your child?*

Ok to Video your child?*

Request to drop student(s)

Please select the classes in which you wish to enroll in. Please note that the tuition will be posted but we will go in and correct it for pro rated/family discounts, if needed.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

What day of the month would you like to be charged?*

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies

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