Registration
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By Registering my child: *My Child has my permission to attend and participate in PARENTS NIGHT OUT AT STARS GYMNASTICS TRAINING CENTER. *In the event of an emergency, I give my permission to Stars Gymnastics Training Center to make the decision to obtain medical care should I be unreachable at the number listed on my account. *I am fully aware that any activity involving motion or height creates the possibility of serious injury or even death and that any athletic activity has certain unavoidable risks. *I further agree to hold harmless Stars Gymnastics Training Center, its teachers, staff and school for any and all injuries resulting and expenses arising out of participation in the event activities *I release and discharge any and all rights and claims against Stars Gymnastic Training Center relating to my child's participation in this event.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Grandparent
Guardian
Mother
Parent
Home Phone:
*
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
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AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
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NJ
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NY
NV
OH
OK
OR
PA
RI
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WA
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Zip:
*
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:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Additional Information:
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
Visa
Mastercard
Discover
Name as it appears on card:
Nickname:
Card Expiration Month:
01
02
03
04
05
06
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08
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10
11
12
Exp Year:
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
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2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
2055
Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
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