Registration
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Welcome to Rhythmic Gymnastics of Indiana Registration Page.
Please register your family here so that we can keep in contact with you better and allow you to track your payments online.
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Referral Information
How did you hear about us?
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Brochure
Demonstration
Fair
Newspaper Ad
Referral
Transfer
Website
Referral Name
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Family Information
Family Last Name
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Where do you live?
Home Address
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City
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State
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AK
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AR
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CT
DC
DE
FL
GA
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ME
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VT
WA
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WV
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PR
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Zip
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Primary Phone
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Additional Info
Health Insurance Carrier
Cell Phone Contact Number
Contact #1
Contact #1 First Name
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Last Name
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Type
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Doctor/Physician
Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
How Can We Contact You?
Home Phone
Work #
Cell #
Portal Access (your email is your login)
Email
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(Emails are kept confidential)
Confirm Email
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Portal Account Password
Confirm Portal Account Password
Contact #2
Contact #2 First Name
Last Name
Type
Doctor/Physician
Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
How can we contact you?
Home Phone
Work #
Cell #
Email
(Emails are kept confidential)
Confirm Email
Student #1
Student's First Name
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Last Name
*
Student Gender
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Female
Male
Birth Date
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Additional Info
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #2
(Show-Hide Details)
Student's First Name
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Last Name
*
Student Gender
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Female
Male
Birth Date
*
Additional Info
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #3
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Additional Info
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #4
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Additional Info
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #5
(Show-Hide Details)
Student's First Name
*
Last Name
*
Student Gender
*
Female
Male
Birth Date
*
Additional Info
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Add Another Student
Required Policies
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I Agree to All of the Above
Enter your Full Name
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December 21, 2024
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