Cooma Gymnastics Club Online Registration

Registration

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Welcome to Cooma Gymnastics Club! Please complete the following registration form. Please note you must select a class for enrolment in order to complete registration.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Postcode*

Primary Phone*

Additional Info

Emergency Contact Info name and number<br/>*

Media permission? Yes or No*

Contact #1

Parent/ Guardian 1 First Name*

Last Name *

Relationship to gymnast*

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

Contact #2

Parent/ Guardian 2 First Name*

Last Name*

Relationship to gymnast*

How can we contact you?

Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Disabilites or Special needs - Please leave blank if NIL

Allergies - Please leave blank if NIL

Media Permission? Yes or no*

Please ensure you Child is enrolled in the class appropriate for their age classification. If your child has skills higher than the enrolled class, an assessment will take place over the term and your child will be moved to another class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Disabilites or Special needs - Please leave blank if NIL

Allergies - Please leave blank if NIL

Media Permission? Yes or no*

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Disabilites or Special needs - Please leave blank if NIL

Allergies - Please leave blank if NIL

Media Permission? Yes or no*

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Disabilites or Special needs - Please leave blank if NIL

Allergies - Please leave blank if NIL

Media Permission? Yes or no*

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Disabilites or Special needs - Please leave blank if NIL

Allergies - Please leave blank if NIL

Media Permission? Yes or no*

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

Postcode*

Registration

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

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)