Registration
This is registration for a Tumbling Clinic. Your card will not be charged at this time. We will have to manually go in and charge it. Please put days you are wanting to enroll in the additional information section. You will receive a receipt via email when your card has been charged. Members $40/day Non-members $45/day
Event:
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
 
 
 
Additional Information:
 
 
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:*