Registration
Gift Certificate: Purchase a gift certificate for family or friends to be redeemed for tuition or merchandise.
Event:
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone:* Click to Enter an International Number Cell #: Click to Enter an International Number Work #: Click to Enter an International Number
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
 
 
 
Questions/Options:
Please enter the amount of the Gift Certificate*
Who are you purchasing the Gift Certificate for?
Will you be picking up the Gift Certificate?*
If you will be picking up the Gift Certificate who will be picking it up?
Do you want the Gift Certificate mailed?*
Please provide name and mailing address if you want the Gift Certificate mailed.
 
Additional Information:
 
Payment Authorization
I hereby authorize Ziggy's Gymnastics Academy to charge my bank, or credit card account for the cost of the gift certificate. I understand that payment will be charged to my account is non-refundable.
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:*