Metro Gymnastics Center Online Registration

Registration

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Metro Gymnastics Center, Inc. Family Registration Form Release, Waiver of Liability, Assumption of Risk, and Indemnity Agreement ("Agreement"). ONLINE enrollment available for Dance, Mini-Movers (Preschool age), Rec Girls Level 1 by age, and Rec Boys. For Rec level 2, 3, 4, please call our office to enroll or to schedule an evaluation if level is unknown. OUR OFFICE WILL RUN ALL PAYMENTS TO YOUR CARD ON FILE at the designated billing times of every 4 weeks during our school year session.

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Health Insurance Carrier*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Girls wear a leotard, or tight short and tuck in t-shirt, hair up in a ponytail and go barefoot.

Boys wear shorts and a t-shirt, go barefoot.

ALL long hair must be tied back from face.

Please bring a water bottle.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Girls wear a leotard, or tight short and tuck in t-shirt, hair up in a ponytail and go barefoot.

Boys wear shorts and a t-shirt, go barefoot.

ALL long hair must be tied back from face.

Please bring a water bottle.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Girls wear a leotard, or tight short and tuck in t-shirt, hair up in a ponytail and go barefoot.

Boys wear shorts and a t-shirt, go barefoot.

ALL long hair must be tied back from face.

Please bring a water bottle.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Girls wear a leotard, or tight short and tuck in t-shirt, hair up in a ponytail and go barefoot.

Boys wear shorts and a t-shirt, go barefoot.

ALL long hair must be tied back from face.

Please bring a water bottle.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Girls wear a leotard, or tight short and tuck in t-shirt, hair up in a ponytail and go barefoot.

Boys wear shorts and a t-shirt, go barefoot.

ALL long hair must be tied back from face.

Please bring a water bottle.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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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

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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

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