Rebounders Gymnastics Online Registration

Registration

Already a customer? Click here to login.

REBOUNDERS GYMNASTICS ONLINE REGISTRATION FORM

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Child's Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Active/Veteran Military Y/N

Contact #1

Parent or Legal Guardian 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

Other Contact Person 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

Name of School*

Medical, psychological, behavioral conditions, or dietary restrictions?

Allergies and/or Medications (Leave blank if NONE)

Medications

Allow child photo Yes/NO*

Notes

Enrollment in an open class begins immediately upon registration. Your account will be charged at checkout. Your enrollment will be active for the specified date and time you registered for.

Please click on the Register Link

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Name of School*

Medical, psychological, behavioral conditions, or dietary restrictions?

Allergies and/or Medications (Leave blank if NONE)

Medications

Allow child photo Yes/NO*

Notes

Enrollment in an open class begins immediately upon registration. Your account will be charged at checkout. Your enrollment will be active for the specified date and time you registered for.

Please click on the Register Link

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Name of School*

Medical, psychological, behavioral conditions, or dietary restrictions?

Allergies and/or Medications (Leave blank if NONE)

Medications

Allow child photo Yes/NO*

Notes

Enrollment in an open class begins immediately upon registration. Your account will be charged at checkout. Your enrollment will be active for the specified date and time you registered for.

Please click on the Register Link

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Name of School*

Medical, psychological, behavioral conditions, or dietary restrictions?

Allergies and/or Medications (Leave blank if NONE)

Medications

Allow child photo Yes/NO*

Notes

Enrollment in an open class begins immediately upon registration. Your account will be charged at checkout. Your enrollment will be active for the specified date and time you registered for.

Please click on the Register Link

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Name of School*

Medical, psychological, behavioral conditions, or dietary restrictions?

Allergies and/or Medications (Leave blank if NONE)

Medications

Allow child photo Yes/NO*

Notes

Enrollment in an open class begins immediately upon registration. Your account will be charged at checkout. Your enrollment will be active for the specified date and time you registered for.

Please click on the Register Link

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)