Registration
Once you are a member of our gym, you will be able to schedule private lessons. Your registration/membership fee will be valid for one year. The registration/membership fee is non-refundable and not pro-rated. You may also enroll in classes later at any time if you wish without owing the registration fee again until your anniversary date. Disregard Date/Time stamped above and/or below.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Parent's Information
First Name:* Last Name: *
Parent/Self if over 18*
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Please list each child who will be taking private lessons and their date of birth (MM/DD/YY) for waiver purposes.*
Which instructor are you wanting to schedule private lessons with?*
 
Additional Information:
 
Assumption of Risk/Release of Liability
  (Show-Hide Details)
I've read the above and agree.
 
Infectious Disease
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I've read the above and agree.
 
Spotting
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I've read the above and agree.
 
Medical Emergencies
  (Show-Hide Details)
I've read the above and agree.
 
Photo/Video Release
  (Show-Hide Details)
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:*