Granite State Gymnastics and Fitness, LLC Online Registration

Registration

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Welcome to Granite State Gymnastics and Tumble Bees Preschool & Fitness! Please complete the following registration form. Please note that classes not meeting minimum size requirements are subject to cancellation. Registration only becomes complete after submitting info on this page, logging in to my portal, and clicking on the Fees & Payment tab to process payment.

* denotes required fields

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 # * Receive Text Message Notifications

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

Email* (Emails are kept confidential)

Confirm Email*

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities? Tips to help with your child's care?

Special Needs (Leave blank if NONE)

Allergies? If your child has an epi pen, a written plan is required.

Medications (if applicable)

Primary Doctor

Photography Release (Yes/No)*

Once registered, please login to my portal. To pay for your class, you have to enter your credit card # and then go into the Fees & Payment tab to process the payment. Entering it alone does not pay the fees.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities? Tips to help with your child's care?

Special Needs (Leave blank if NONE)

Allergies? If your child has an epi pen, a written plan is required.

Medications (if applicable)

Primary Doctor

Photography Release (Yes/No)*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities? Tips to help with your child's care?

Special Needs (Leave blank if NONE)

Allergies? If your child has an epi pen, a written plan is required.

Medications (if applicable)

Primary Doctor

Photography Release (Yes/No)*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities? Tips to help with your child's care?

Special Needs (Leave blank if NONE)

Allergies? If your child has an epi pen, a written plan is required.

Medications (if applicable)

Primary Doctor

Photography Release (Yes/No)*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities? Tips to help with your child's care?

Special Needs (Leave blank if NONE)

Allergies? If your child has an epi pen, a written plan is required.

Medications (if applicable)

Primary Doctor

Photography Release (Yes/No)*

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

Where do you live?

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)