Rainbow Gymnastics and Cheer Center Online Registration

Registration

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Welcome to Rainbow Gymnastics and Cheer Center! This form should be mobile-friendly, but if you have any difficulty with it, please let us know by calling 731-285-5100, or message us through our Facebook page "Rainbow Gymnastics and Cheer Center (RGC").

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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*

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

School

Grade Level

Allergies*

Primary Doctor*

Skill Notes

Girls should wear either a leotard or T-shirt with shorts or leggings. Boys should wear T-shirt with shorts or sweats. We do have a pro shop with leotards, shirts and shorts available for sale. Girls should have their hair pulled up in a pony tail or braids, unless it's too short. No shoes, socks or jewelry should be worn (exception: small post earrings are acceptable). Parents are allowed, but not required, to watch class from the bleachers upstairs, but should not enter the gym area.

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School

Grade Level

Allergies*

Primary Doctor*

Skill Notes

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

School

Grade Level

Allergies*

Primary Doctor*

Skill Notes

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

School

Grade Level

Allergies*

Primary Doctor*

Skill Notes

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

School

Grade Level

Allergies*

Primary Doctor*

Skill Notes

Enroll in Classes

Select Class

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Required Policies and Agreements

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Enter your Full Name*

Questions or Concerns

Comments

Payment Information

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Exp Month *

Exp Year *

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Name as it appears on card *

Address Line 1

Address Line 2

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