Registration

Event:
Start Date/Time: End Date/Time:
Fee per Student: 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
(Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Liability Release
I understand there may be risk of injury associated with this activity. I agree to accept those risks and allow my child to participate. I agree to indemnify and hold harmless Athletic Perfection and their employees against any and all liability for any injury which may be suffered by my child arising out of or in any way connected with participation in the programs sponsored by Athletic Perfection.
I've read the above and agree.
 
Virtual Training Consent
By your child participating in this Virtual program with Athletic Perfection:
You agree, represent, and warrant that:
1)Your child is in a safe space, free of obstructions environment.
2) Your child is on a safe training surface.
3) Your child is wearing the proper attire to do the workout .
4) Your child is working out at his/her own risk, and if he/she feels uncomfortable doing any activity, he/she has the right to opt out

You further agree that the Liability Release you executed prior to joining Athletic Perfection's Virtual program shall extend and apply to this Virtual service, including but not limited to limitation of liability, indemnification, and assumption of risk.

In the event the participant is a minor, you, as the parent or legal guardian, agree to the above on behalf of yourself and your minor child. You further agree that you will observe and monitor your minor child during the course of the activity.

I've read the above and agree.
 
Payments
Payments are charged monthly and are automatically charged to the credit card on file.
I've read the above and agree.
 
Photo Release
I agree to allow Athletic Perfection to use my child in pictures for the Athletic Perfection website and other advertising purposes.
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:*