The Gymnastics and Cheerleading Academy Online Registration

Registration

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Welcome to The Gymnastics and Cheerleading Academy! We're excited to to have you join our Flipping Family! Please complete the following registration form.

* 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)*

Health Insurance Carrier*

Contact #1

Contact #1 First Name*

Last Name *

Type

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

Contact #2 First Name*

Last Name*

Type

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* (format=mm/dd/yyyy)

Additional Info

School*

Grade Level Entering in the Fall*

Diseases*

Disabilites*

Special Needs*

Allergies*

Medications*

Primary Doctor*

Did you Fax, mail, or email over Immunization Records? (Campers mandatory)*

Additional Information about your child*

Have you attended camp before?

Do you have any fears?

Can you swim?

How do you feel about Camp?

Campers Nickname (if applies)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School*

Grade Level Entering in the Fall*

Diseases*

Disabilites*

Special Needs*

Allergies*

Medications*

Primary Doctor*

Did you Fax, mail, or email over Immunization Records? (Campers mandatory)*

Additional Information about your child*

Have you attended camp before?

Do you have any fears?

Can you swim?

How do you feel about Camp?

Campers Nickname (if applies)

Please click on the Search button below, then choose the class.

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

School*

Grade Level Entering in the Fall*

Diseases*

Disabilites*

Special Needs*

Allergies*

Medications*

Primary Doctor*

Did you Fax, mail, or email over Immunization Records? (Campers mandatory)*

Additional Information about your child*

Have you attended camp before?

Do you have any fears?

Can you swim?

How do you feel about Camp?

Campers Nickname (if applies)

Please click on the Search button below, then choose the class.

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

School*

Grade Level Entering in the Fall*

Diseases*

Disabilites*

Special Needs*

Allergies*

Medications*

Primary Doctor*

Did you Fax, mail, or email over Immunization Records? (Campers mandatory)*

Additional Information about your child*

Have you attended camp before?

Do you have any fears?

Can you swim?

How do you feel about Camp?

Campers Nickname (if applies)

Please click on the Search button below, then choose the class.

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

School*

Grade Level Entering in the Fall*

Diseases*

Disabilites*

Special Needs*

Allergies*

Medications*

Primary Doctor*

Did you Fax, mail, or email over Immunization Records? (Campers mandatory)*

Additional Information about your child*

Have you attended camp before?

Do you have any fears?

Can you swim?

How do you feel about Camp?

Campers Nickname (if applies)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Assumption of Risk/Release of Liability

As a condition to participate in any programs at THE GYMNASTICS AND
CHEERLEADING ACADEMY, I hereby release and forever discharge THE
GYMNASTICS AND CHEERLEADING ACADEMY, any of its employees, or
any individuals acting on its behalf, and connected with this program in which
I or my child(ren), may participate, from any and all claims, demands, or losses
of every kind of nature wich may result to my child(ren) myself or my heirs. I
recognize and acknowledge all risks involved in the participation in the above
program and assume all risks inherent in the participation in the same.
THE GYMNASTICS AND CHEERLEADING ACADEMY has permission to
take and display photographs for the waiting area monitor.
For safety reasons, all parents are requested to pick children up inside the
building promptly at the end of class. All of our equipment may be used in
any of our classes.

I've read the above and agree.

Release of Liability

I've read the above and agree.

Payment/Make Up/Refund Policies

Payment terms: Please make all Payments, Tuition and Registration, before
attending your first class or day of camp.

School Year Classes - $30 non-refundable registration fee for one student or $50 per family is due with application.
Summer Classes - $20 non-refundable registration fee per student is due with application for all students
not previously enrolled in the current school year.
All missed Classes must be made up before the end of that session and
may not be credited to succeeding sessions. There are two make ups permitted per
session. No refunds are given for missed classes. Make ups for missed classes are
made by attending a regularly scheduled class of the same level. To make up a class,
a parent/guardian of the child is to call and schedule in advance. Make-ups will be
scheduled upon availability.
2 Week Notice for cancellations plus a $25 fee.

Camp - Applications accepted on first come and first serve basis.
$50 non-refundable registration fee due with application for all students
not previously enrolled at the Academy for our current school year of
September 1, 2018 through August 31, 2019.

Camp - Minimum $200.00 deposit due with application (or payment in full if tuition
is less than $200.00). Deposit refundable prior to May 1, 2019,
less $50 service fee. Written notice must accompany all requests.
Balances due by May 15, 2019.
Payment must be made in full when applying after May 15, 2019. All balances
due prior to the start of the week in question.

Camp - No refunds for absences or withdrawals without a 2 week written
notice. $100 Cancellation Fee. Written request required.
Transfers between weeks will only be permitted if space is available.
$25 Transfer Fee per request. Written request required. All written notices must
be received at least 2 weeks prior to the start of week in question.

I've read the above and agree.

Medical Emergencies/Transport

*Medications will not be administered to Campers at any time during Camp hours.

Please make sure to input contact info in case of an emergency.

For Campers - As a parent/legal guardian, I give consent to have my child receive
first aid by facility staff, and if necessary, be transported to receive emergency care.
As a parent/legal guardian I will be responsible for all charges not covered by insurance.

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

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number