TEGA Kids Superplex Online Registration

Registration

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Welcome to TEGA Kids Superplex online registration! Please complete the information below for quick and easy enrollment, and click SUBMIT when finished. We review each registration as it comes through, and will apply any registration fees and/or applicable discounts. Credit cards will not be charged until we review your registration!

Please list your child's LEGAL first and last name on the form. Any nicknames can be noted in the comments. Thank you!

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info/Authorized Pickups*

Contact #1

Parent/Guardian First Name*

Last Name *

Relationship*

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

Relationship

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* (format=mm/dd/yyyy)

Additional Info

School

Grade Level

Restrictions or Special Needs (Type NA if none)*

Allergies (Type NA if none)*

Medications (Leave blank if none)

Primary Doctor

Please select your child's classes below (you may create an account without selecting classes). Class spots may not be reserved for future dates. Your registration will become active upon receipt*. If you have any concerns, please contact our Accounts Manager prior to enrolling. Monthly tuition will be pro-rated according to your start date if applicable. Please be sure to read our policies in detail for important information regarding billing.

*If enrolling into a childcare class (preschool or after school care) our office will contact you within 2 days to notify you of your child's start date. All additional paperwork must be submitted prior to your child's first day of care.

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

School

Grade Level

Restrictions or Special Needs (Type NA if none)*

Allergies (Type NA if none)*

Medications (Leave blank if none)

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

School

Grade Level

Restrictions or Special Needs (Type NA if none)*

Allergies (Type NA if none)*

Medications (Leave blank if none)

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

School

Grade Level

Restrictions or Special Needs (Type NA if none)*

Allergies (Type NA if none)*

Medications (Leave blank if none)

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

School

Grade Level

Restrictions or Special Needs (Type NA if none)*

Allergies (Type NA if none)*

Medications (Leave blank if none)

Primary Doctor

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*

Jackrabbit Technologies' class management platform & registration portal is trusted by 1000s of
dance studios , gyms , swim schools , music schools , cheer gyms , childcare centers , and more .

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)