Registration
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Mini Movers is open gym just for little ones and their grown-ups, (tots age 0-4 only -- no big kids allowed!) Admission is $5 per tot (grown-ups and infants not yet crawling are free) and will be charged upon registration to save your spot. Absences, open gym passes, and unlimited open gym may be used for mini movers. If you have a pass, please note it in your registration! Pre-registration required! Save time at check-in and complete your waiver online at - https://smartwaiver.com/v/gymco
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Contact Information
First Name:
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Last Name:
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Type
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Aunt
Father
Friend/Neighbor
Grandparent
Mother
Nanny
Other
Parent
Step Father
Step Mother
Uncle
Home Phone:
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Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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AK
AL
AR
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CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
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KY
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ME
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OH
OK
OR
PA
RI
SC
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WA
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Zip:
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Last Name:
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Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Medical, Psychological or Behavioral Conditions?:
Allergies or Dietary Restrictions:
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Medical, Psychological or Behavioral Conditions?:
Allergies or Dietary Restrictions:
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Medical, Psychological or Behavioral Conditions?:
Allergies or Dietary Restrictions:
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Medical, Psychological or Behavioral Conditions?:
Allergies or Dietary Restrictions:
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Medical, Psychological or Behavioral Conditions?:
Allergies or Dietary Restrictions:
Additional Information:
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
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Exp Year:
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2024
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Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
*
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