Registration
3 openings left in this event!
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Please make sure to sign in to your Parental Portal to Select your Class(es) after filling out the Registration Form.
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
Caregiver
Father
Guardian
Mother
Self
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
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
NE
NC
ND
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NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
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UT
VA
VT
WA
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WV
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Zip:
*
Emergency Contact Info
(Not Contact #1 or #2)
*
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Grade Level Entering in the Fall:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Have you attended camp before?:
Do you have any fears?:
Can you swim?:
How do you feel about Camp?:
Campers Nickname (if applies):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Grade Level Entering in the Fall:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Have you attended camp before?:
Do you have any fears?:
Can you swim?:
How do you feel about Camp?:
Campers Nickname (if applies):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Grade Level Entering in the Fall:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Have you attended camp before?:
Do you have any fears?:
Can you swim?:
How do you feel about Camp?:
Campers Nickname (if applies):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Grade Level Entering in the Fall:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Have you attended camp before?:
Do you have any fears?:
Can you swim?:
How do you feel about Camp?:
Campers Nickname (if applies):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Grade Level Entering in the Fall:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities:
*
Allergies:
*
Medications:
*
Primary Doctor:
*
Have you attended camp before?:
Do you have any fears?:
Can you swim?:
How do you feel about Camp?:
Campers Nickname (if applies):
Questions/Options:
Any medical conditions we should be aware of?
*
Who will be picking your student up? List any possibilities.
*
Please make sure to log in to your Parent Portal, after Registering, to pick which Summer Class(es) you want.
Additional Information:
Assumption of Risk/Release of Liability
(Show-Hide Details)
As a condition to participate in any programs at THE GYMNASTICS AND CHEERLEADING ACADEMY, I hereby release and forever discharge THE GYMNASTICS AND CHEERLEADING ACADEMY, any of its employees, or any individuals acting on its behalf, and connected with this program in which I or my child(ren), may participate, from any and all claims, demands, or losses of every kind of nature wich may result to my child(ren) myself or my heirs. I recognize and acknowledge all risks involved in the participation in the above program and assume all risks inherent in the participation in the same.
THE GYMNASTICS AND CHEERLEADING ACADEMY has permission to take and display photographs for the waiting area monitor.For safety reasons, all parents are requested to pick children up inside the building promptly at the end of class. All of our equipment may be used in any of our classes.
I've read the above and agree.
Payment/Make Up/ Refund Policies
(Show-Hide Details)
Please make all payments by cash, check, or credit card.
$20 non-refundable registration fee per student is due with application for all students
not previously enrolled in the current school year.
All missed Classes must be made up before the end of that session and
may not be credited to succeeding sessions. There are two make ups permitted per
session.
No refunds are given for missed classes. Make ups for missed classes are
made by attending a regularly scheduled class of the same level. To make up a class,
a parent/guardian of the child is to call and schedule in advance. Make-ups will be
scheduled upon availability.
2 Week Notice for cancellations plus a $25 fee.
Please note: Due to Insurance regulations, any incomplete applications received will be returned to sender. Terms of insurance policy are available upon request.I have read, understand and agree to adhere to the policies of THE GYMNASTICS AND CHEERLEADING ACADEMY.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
Visa
Mastercard
Amex
Name as it appears on card:
Nickname:
Card Expiration Month:
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Exp Year:
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
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2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
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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