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

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

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

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

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

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

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

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

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

Add Another Student

Required Policies and Agreements

Photos

We take many pictures of our classes, camps and events to use for our website and social media (Yelp, Facebook, Redwood City Patch etc). If you are not comfortable with your childs picture being used please inform the staff.

I've read the above and agree.

DROPS

ALL DROP MUST BE IN WRITING via walk-in or email before the last day of the month. info@bayshoreelte.com

I've read the above and agree.

Assumption of Risk

SPORTS PARTICIPATION CAN BE DANGEROUS. I recognize that participation in activities such as gymnastics, tumbling, trampoline, martial arts, dance, cheerleading, ball sports and rock climbing can result in severe injuries, permanent paralysis, brain damage, or even death. I am also aware that participation in some activities such as day camp involves transportation to and from field trips, which carries the risk of injury or death by vehicular accident.

I've read the above and agree.

Refund Policy

NO REFUNDS GIVEN

I've read the above and agree.

Release of Liability

ON BEHALF OF MYSELF AND MY CHILD(REN), I ACCEPT ALL SUCH RISKS AND PROMISE NOT TO SUE, AND FOREVER RELEASE BAYSHORE ELITE LLC, and their officers, directors, shareholders, employees, contractors, invitees, licensees, and agents ("you") from all liability for damages or injuries incurred as a result of participation by my child(ren) or myself. This includes resulting from acts of negligence by you. I also waive all rights any third party may otherwise have to pursue claims against you on my behalf (including the right of subrogation). If despite this agreement, I or any third party on my behalf makes a claim against you, I will defend, hold harmless and reimburse you for such claim and liabilities incurred as a result of such claim.

I've read the above and agree.

Medical Emergencies

In the event of an accident or emergency I AUTHORIZE MY CHILD(REN) TO BE TRANSPORTED TO A MEDICAL FACILITY FOR TREATMENT, at my cost, and will hold you harmless in your management of such accident or emergency. I agree to provide for all medical expenses which may be incurred by myself or my child(ren) as a result of any injury while on your premises or while under your care. I am aware that photos and videos are taken from time to time for marketing and instructional purposes and I hereby consent to their use by you. I have read and understand this Assumption of Risk, Waiver of Liability, Medical Authorization and Photo Release.

I've read the above and agree.

Payment Policies

Class tuition payments are due on the 1st of each month. $25.00 Late fees are put on late accounts after the 7th of the month.
Camp tuition is due in full before camps start (i.e. Summer Camp, Spring Break Camp, Winter Camp, Veterans Day Camp etc.)
BY CHECKING THIS YOU AGREE TO AUTOMATICALLY CHARGED YOUR CREDIT CARD ON FILE ON THE FIRST OF EACH MONTH FOR MONTHLY TUITION UNLESS NOTIFIED IN WRITING BEFORE THE LAST DAY OF THE MONTH.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

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*