Bayshore Elite - Middlefield Online Registration

Registration

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Bayshore Elite Gymnastics Middlefield Gym

* 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
(Not Contact #1 or #2)

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

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

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Girls can wear a leotard, unitard, or shorts and a tee shirt. ( clothing must be tight fitting, no baggy clothing ) Hair must be in a pony tail or bun. No hanging jewelry. i.e. neckless, bracelet or dangling earring's. Boys can wear shorts and tee shirt or tank top. (no baggy clothing, no pocket shorts).

Enroll in Classes

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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

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Add Another Student