Registration

Registration

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This is an unstructured practice period exclusively for ages 11+ (or students at blue level or above). This is their chance to utilize the equipment and gym space.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

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

	Address: *
	City: *	State: * Zip: *
	Name & phone of an adult LIVING OUTSIDE YOUR HOME if unable to reach you in case of emergency*

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)
	Disabilities:*
	Allergies:*
	Medications:*

Add New Student #2:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities:*
	Allergies:*
	Medications:*

Add New Student #3:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities:*
	Allergies:*
	Medications:*

Add New Student #4:

(Show-Hide Details)

	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities:*
	Allergies:*
	Medications:*

Add New Student #5:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)

	Disabilities:*
	Allergies:*
	Medications:*

Additional Information:

Communications Policy 2022

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EncoreGym uses email as our primary mode of communications with families. Please be sure to check your email regularly for announcements and updates. We recommend adding office@encoregym.com, encoregymfrontdesk@gmail.com, and noreply@jackrabbittech.com to your contacts to avoid missing important information because of spam filters. You may also opt-in to receive text alerts; these are used for urgent messaging only.

I've read the above and agree.

Events 2024

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EVENTS: Special events (including, but not limited to, Itty Bitty Buddy Blast, Open Gym, and Parents' Nights Out) require advance registration and are open to all children in the age range specified for each individual event.

Current annual membership is not required to attend special events.

Admission fees in full are due and payable immediately at time of registration.

No discounts, credits, or make-up visits are offered or accepted for events.

All event registrations are final; no cancellations, transfers, or refunds are accepted.

Late pick-ups: a late fee of $20 per child will be due and payable immediately for any late pick-ups, beginning 15 minutes after the published end of camp. An additional $20 per child will be charged for each/any additional 15-minute increments.

Due to safety concerns, special requirements/protocol must be followed during all events. All participants and observers age 36 months and older, and all staff, may be required to wear face masks at all times within the facility. **As of 3/28/2022, the mask requirement has been suspended until further notice, but this policy is subject to change in accordance with state and local mandate.

I've read the above and agree.

Cancellation Policy

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Payment is due at time of event registration and is non-refundable. Should I need to cancel this event registration for any reason, I agree to notify EncoreGym no fewer than 48 hours prior to the event start time in order to receive credit for future use. Any cancellations received less than 48 hours prior to the event start time will receive no credit. No credit is granted for no-shows.

I've read the above and agree.

Participants

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I understand that all camp participants must be fully toilet-trained and able to use the bathroom independently.

I've read the above and agree.

Safety Policy 2022

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All students, parents, and visitors must read and follow posted safety rules at all times. Failure to do so will result in ejection from the gym, with no refund.

Due to safety concerns, special requirements/protocol must be followed during all classes, camps, events, and parties. All participants and observers age 36 months and older, and all staff, may be required to wear face masks at all times within the facility. **As of 3/28/2022, the mask requirement has been suspended until further notice, but this policy is subject to change in accordance with state and local mandate.

I've read the above and agree.

Privacy and Security Policy 2022

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PRIVACY: EncoreGym respects your privacy. Although we may collect personally identifiable information when you visit our website, please be assured that we will NEVER sell, rent, share, nor otherwise distribute your information to ANY third party. Your personal information will be used at our discretion to update and maintain your family's registration accounts and to keep you informed of gym news and special events that may interest your family. SECURITY: Your personal and payment information is always safe. Our software employs Secure Socket Layer (SSL) technology to encrypt all of your personal information, including credit card number, name, and address, so that it cannot be read over the internet.

I've read the above and agree.

Payment Policies 2022

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For all weekly classes, registration/membership fees and tuition are non-refundable and non-transferable. All enrollments in weekly classes are final.

Each session's tuition will be charged at current rates which are subject to change.

CHECKS: Personal checks will not be accepted as payment.

NSF: You will be responsible to pay a processing fee of a minimum of $25 for any payment that is returned unpaid by your bank for any reason, or for any payment that is refunded for any reason.

AUTOPAY POLICY: For your convenience, we use an automatic payment system, which will charge your family's tuition and associated fees to your credit or debit card immediately upon enrollment. Each subsequent session's tuition and/or any other outstanding fees will then be charged to your autopay card beginning on the 20th of the month, in advance of the start of each subsequent session. Entering your credit card payment information in this form means that you agree to this, and that both enrollment and payments will continue until/unless you notify us in advance of your intention to withdraw from all classes.

Advance written withdrawal ("Drop") notice is required and must be received by the 15th of the month, to allow for time to cancel your billing prior to the next billing cycle.

I've read the above and agree.

Assumption of Risk 2022

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As legal guardian for the student(s) listed on this form, I consent to their participation in the Encore, Inc. program. I realize the potential for injuries, including permanent paralysis or death, when participating in any activity involving motion and height. I understand that it is the intent of Encore, Inc. to provide for the safety and protection of all students including my child, and injuries may still occur. I understand that students are not allowed in the activity areas without an instructor.

I've read the above and agree.

Release of Liability 2022

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In consideration for my child being allowed to use Encore, Inc. facilities, I hereby forever release Encore, Inc. and its employees from all liability and for all damages and injuries occurring under the instruction and supervision of Encore, Inc. I understand that it is my responsibility to ensure the safety of my child in the parking lot, and that Encore, Inc. assumes responsibility within the premises. As legal guardian, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of injury sustained while training at or performing for Encore, Inc. I understand that Encore, Inc may take pictures/video of me and/or my child for use with their marketing or website.

I've read the above and agree.

Medical Emergencies 2022

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In the event of illness or injury, I give my permission to the Encore, Inc. staff trained in First Aid, as well as medical professionals, to administer emergency medical treatment to my child.

I've read the above and agree.

Enter your Full Name:

*

Other Questions/Comments:

Credit Card Verification:

Card Number: *

Name as it appears on card: *

Nickname:

Card Expiration Month: *

Exp Year: *

Address Line 1:

Address Line 2:

City:

State: Zip:*

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