Transform Academy Online Registration

Registration

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Welcome to Transform Academy! Please fill out the form below. You will be prompted to sign an online waiver upon enrollment, please be sure to read through all policies and agreements before signing. Also note that while we require that credit card be on file for all for your account, entering your card information will not automatically charge your card unless you set up auto-pay to pull on the 1st or 15th of the each month. All unpaid tuition will be pulled on the 20th of every month

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Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Health Insurance Carrier*

Contact #1

Contact #1 First Name*

Last Name *

Type*

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name*

Last Name*

Type*

How can we contact you?

Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please read the class description for details to ensure your are signing up for the correct class.
Please wait in the lobby area until it's time for your for class. At our Osky/University Park location, this is the DOWNSTAIRS LOBBY AREA, please do not go upstairs to the stage until 5 minutes for your class starts.
Upon entering the building, students and spectators must remain in the lobby area. At our Osky/University Park gym, students should not come upstairs to the gym until 5 minutes before class starts.
Students must bring a water bottle with them to class. All other personal items must remain in the lobby area.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please read the class description for details to ensure your are signing up for the correct class.
Please wait in the lobby area until it's time for your for class. At our Osky/University Park location, this is the DOWNSTAIRS LOBBY AREA, please do not go upstairs to the stage until 5 minutes for your class starts.
Upon entering the building, students and spectators must remain in the lobby area. At our Osky/University Park gym, students should not come upstairs to the gym until 5 minutes before class starts.
Students must bring a water bottle with them to class. All other personal items must remain in the lobby area.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please read the class description for details to ensure your are signing up for the correct class.
Please wait in the lobby area until it's time for your for class. At our Osky/University Park location, this is the DOWNSTAIRS LOBBY AREA, please do not go upstairs to the stage until 5 minutes for your class starts.
Upon entering the building, students and spectators must remain in the lobby area. At our Osky/University Park gym, students should not come upstairs to the gym until 5 minutes before class starts.
Students must bring a water bottle with them to class. All other personal items must remain in the lobby area.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please read the class description for details to ensure your are signing up for the correct class.
Please wait in the lobby area until it's time for your for class. At our Osky/University Park location, this is the DOWNSTAIRS LOBBY AREA, please do not go upstairs to the stage until 5 minutes for your class starts.
Upon entering the building, students and spectators must remain in the lobby area. At our Osky/University Park gym, students should not come upstairs to the gym until 5 minutes before class starts.
Students must bring a water bottle with them to class. All other personal items must remain in the lobby area.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please read the class description for details to ensure your are signing up for the correct class.
Please wait in the lobby area until it's time for your for class. At our Osky/University Park location, this is the DOWNSTAIRS LOBBY AREA, please do not go upstairs to the stage until 5 minutes for your class starts.
Upon entering the building, students and spectators must remain in the lobby area. At our Osky/University Park gym, students should not come upstairs to the gym until 5 minutes before class starts.
Students must bring a water bottle with them to class. All other personal items must remain in the lobby area.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule

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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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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