Gymnastics ETC Online Registration

Registration

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Welcome to Gymnastics ETC! Please provide your information below and click Submit when complete. Please only fill out one form per family. You can add additional students under the "Student 2" tab, etc... Discounts will not show online but will be applied prior to billing tuition. Tuition will be billed monthly on the 1st or 10th, please select in e-payment schedule. A $50 registration fee will post to your account and draft within 24-48 hours of registration. This fee is non-refundable.

* 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

Who is your employer?

Employer

Employer Phone

Employer Notes

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

These classes will start AUGUST 5, 2019 and end JULY 31, 2020.

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

These classes will start AUGUST 5, 2019 and end JULY 31, 2020.

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

T-Shirt Size

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

These classes will start AUGUST 5, 2019 and end JULY 31, 2020.

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

T-Shirt Size

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

These classes will start AUGUST 5, 2019 and end JULY 31, 2020.

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

T-Shirt Size

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

These classes will start AUGUST 5, 2019 and end JULY 31, 2020.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Assumption of Risk

By the very nature of the activity, gymnastics and other gymnastics related sports carry a risk of physical injury. No matter how careful the athlete and coach are, no matter how many spotters are used, no matter what height is used or what landing surface exists, the risk cannot be eliminated. The risks of injury include minor injuries such as bruises and more serious injuries such as broken bones, dislocations and muscle pulls. The risks also include catasrophic injuries such as permanent paralysis or even death from landings on the back neck or head.

I've read the above and agree.

Release of Liability

I am fully aware of and appreciate that gymnastics related activities involve motion, rotation and height and, therefore, creates the possibility of serious accidental injury. I agree to assume liability for all medical costs and other damages resulting from injury to my child (myself) not occasioned by gross negligence or willful misconduct of an employee of Gymnastics Elite Training Center, Inc. Further, I agree to hold Gymnastics Elite Training Center, Inc. and its staff harmless from any liability resulting from any such injury.

I've read the above and agree.

Medical Emergencies

I hereby release the Gymnastics Elite Training Center, Inc. coaches and staff to render temporary first aid to my child in the event of injury during the course of classes or other functions being conducted at Gymnastics Elite Training Center, Inc.

I've read the above and agree.

Payment Policies

I understand that I am responsible for payment of tuition fees for my child's classes whether or not my child attends class until the time at which I notify Gymnastics Elite Training Center, Inc. of my desire to cancel my child's enrollment with a 30 day notice in writing. DROP FORM MUST BE FILLED OUT AND SIGNED IN PERSON.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Please fill out ONE of the following Payment Methods

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

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number