Registration
Need an evening without the kids? Rising Star Gymnastics Training Center Night Out gives our parents the opportunity to take a well-deserved break. Go out for a night on the town feeling confident that your little ones are safe and having the time of their lives . This incredible evening for your children is filled with a variety of fun games and activities, so exciting, they won't want the night to end! MEMBERS - $55 (2nd child $30 if member). NON-MEMBERS - $60 (2nd child $35 if non-member). We will adjust the registration fee before charging your card. DO NOT PROCESS YOUR CARD - WE WILL PROCESS IT WHEN IT AND BEEN REVIEWED AND EDITED WITH PROPER FEES!
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: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Insurance Company*
Policy #*
Type of Insurance: Employer/Individual/Government/Medicaid/ Medicare/Tricare*
 
Additional Information:
 
 
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:*