Rainbow Gymnastics and Cheer Center Online Registration

Registration

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* 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*

Home or 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

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

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Primary Doctor*

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Primary Doctor*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Primary Doctor*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Primary Doctor*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Primary Doctor*

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Assumption of Risk

My child and I are aware that participating in gymnastics and/or cheerleading is a potentially hazardous activity. I assume all risks associated with participation in this sport, including but not limited to falls, contact with other participants, the effects of the weather, traffic, and other reasonable risk conditions associated with the sport. All such risks to my child are known and understood by me. I hereby agree to assume all such risk or loss, damage or injury to the person and property of my child and to release and indemnify Rainbow Gymnastics & Cheer (RGC) and its agents and employees, from any and all such claims from loss, damage or injury sustained by me/my child while engaging in such activity. I understand this informed consent form and agree to its conditions on behalf of by child.