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:* Cell #: Work #:
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?
If you wish to credit a child's Ziggy account please provide the child's name and their date of birth.
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 the payment 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:*