Starz Gymnastics and Trampoline Fun Jump Online Registration

Registration

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Welcome to Starz Gymnastics. We're excited for you to join us for our unique Tumbling and Trampoline Gymnastics / Ninja Zone / Aerial Silks classes. Please note before continuing that if your child joins classes, your first payment will include a $52 Yearly Registration Fee in addition to a prorated or full first month's tuition depending on when you register. If attending a TRIAL class, you will be charged only $10 until agreeing to signing up for classes which will include the above.

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Referral Information

How did you hear about us?*

Referral Name*

Family Information

Parent's Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Mother's Birthday*

Father's Birthday*

Who will pay for tuition?*

Contact #1

Mother's First Name*

Last Name *

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

Father's First Name*

Last Name*

How can we contact you?

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*

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Previous illness or injury?*

Previous gymnastics exp?*

Where did he/she attend?*

How long?*

Please be sure to read all of the policies below before checking the boxes. Upon completion of this form, you will be redirected to our waiver. We cannot allow your child to attend classes with us until we receive a waiver, so we ask that you fill this out PRIOR to the first day of class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Previous illness or injury?*

Previous gymnastics exp?*

Where did he/she attend?*

How long?*

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Previous illness or injury?*

Previous gymnastics exp?*

Where did he/she attend?*

How long?*

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Previous illness or injury?*

Previous gymnastics exp?*

Where did he/she attend?*

How long?*

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Previous illness or injury?*

Previous gymnastics exp?*

Where did he/she attend?*

How long?*

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*

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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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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)