The Master's School of Gymnastics Online Registration

Registration

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Please fill out this form as thoroughly as you can. Items marked with a red asterisk are required to submit the form. Anything entered here will override the information we have currently in our system. This new system requires a valid credit card to be on file for each account, but you will still have the power to detemine the method of your payment in the office. All information on this form is kept confidential and will not be shared with anyone outside our offices.

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Referral Information

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Referral Name*

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Family Last Name*

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Home Address*

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Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Health Insurance Carrier*

Contact #1

Primary Parent/Guardian First Name*

Last Name *

Type*

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Second Parent/Guardian First Name

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Work #

Cell # Receive Text Message Notifications

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Confirm Email

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Employer

Employer Phone

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Student #1

Student's First Name*

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T-Shirt Size

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Primary Doctor

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Student's First Name*

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T-Shirt Size

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Primary Doctor

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Additional Info

T-Shirt Size

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Primary Doctor

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Exp Year *

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Address Line 1

Address Line 2

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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

Student #2 (Show-Hide Details)

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Student #3 (Show-Hide Details)

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