Registration

3 openings left in this event!

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family and Information

	First Name:*	Last Name: *
	Relationship to Student*
	Home Phone:*	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Who do we contact in case of an emergency (Name, Phone #, & relationship to student)?*

Students entered below will be added to your family's account

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	School:	Grade Level:
	Any Disabilities we should be aware of?:*
	Does the student have any medication intolerances or allergies (whether environmental or medical)?:*
	Does the student require any special medications?:*
	Who is the Students primary Doctor & Phone number?:*
	May we use child's image?:*
	Trial Class Only ? (Yes or No):*

Add New Student #2:

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Questions/Options:


Is your child a GymStars member?
What is their tumbling experience? And skills they would like to work on?
May we use your child's image for marketing, advertising and training?

Additional Information:

Event Registration is Non-Refundable

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