Gymstars Brooklyn Online Registration

Registration

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Welcome to GYMSTARS! Please provide the information below and SUBMIT. Watch your email for important information. There is a $40 Annual Registration Fee (Non-Refundable) for administrative costs. We look forward to tumbling, dancing or moving with you soon!

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Primary Phone*

Additional Info

Emergency Contact Info

SPECIAL NOTES?

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell #

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gymstars Brooklyn. Standard message and data rates apply. Reply STOP to opt out

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gymstars Brooklyn. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Any Special Considerations?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SCHOOL PICK UP?

TEACHER / LOCATION?

FRIENDS TO GROUP W?

P/U TO WHAT CLASS?

DROP IN TO WHAT CLASS?

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Any Special Considerations?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SCHOOL PICK UP?

TEACHER / LOCATION?

FRIENDS TO GROUP W?

P/U TO WHAT CLASS?

DROP IN TO WHAT CLASS?

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Any Special Considerations?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SCHOOL PICK UP?

TEACHER / LOCATION?

FRIENDS TO GROUP W?

P/U TO WHAT CLASS?

DROP IN TO WHAT CLASS?

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Any Special Considerations?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SCHOOL PICK UP?

TEACHER / LOCATION?

FRIENDS TO GROUP W?

P/U TO WHAT CLASS?

DROP IN TO WHAT CLASS?

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Any Special Considerations?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SCHOOL PICK UP?

TEACHER / LOCATION?

FRIENDS TO GROUP W?

P/U TO WHAT CLASS?

DROP IN TO WHAT CLASS?

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

Registration

Referral Information

Family Information

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

(Show-Hide Details)