Gym Like This! Online Registration

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WELCOME to GYM LIKE THIS! Where KIDS Love to train If you are a NEW member, please proceed. If you are a current or returning family, please log into your parent portal to proceed. We look forward to seeing you in the gym!

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Referral Information

How did you hear about us?*

Referral Name

Family Last Name

Family/Familia Last Name*

Where do you live?

Home Address*

City*

State/Estado*

Zip*

Primary Phone*

Additional Info

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

Health Insurance*

Authorized Pick Up List*

How did you hear about us?*

Contact #1

First Name*

Last Name *

Mother*

How Can We Contact You?

Home Phone

Work #

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

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

First Name

Last Name

Father

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

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*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Any Disabilities

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

What is your Shirt Size?*

Please click on the Search button below, then choose the class. If you are a new member seeking a TRIAL CLASS ($35.00 per student) type Trial Class in the comment box. You will receive an email confirmation upon scheduling.

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Any Disabilities

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

What is your Shirt Size?*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Any Disabilities

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

What is your Shirt Size?*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Any Disabilities

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

What is your Shirt Size?*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Gym Like This!. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Any Disabilities

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

What is your Shirt Size?*

Enroll in Classes

Select Class

Add Another Student

Required Policies

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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/Estado

Zip*

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Registration

Referral Information

Family Last Name

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

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Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

Additional Info

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Student #4 (Show-Hide Details)

Additional Info

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Student #5 (Show-Hide Details)

Additional Info

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I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

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