Explosion Gymnastics Online Registration

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Welcome to Explosion Gymnastics and Explosion Cheer Academy

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Referral Information

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Family Information

Family Last Name*

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Home Address*

City*

Province*

Postal Code*

Primary Phone*

Additional Info

Enter Coupon #

Contact #1

Contact #1 First Name*

Last Name *

Type*

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Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

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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*

Additional Info

Special Needs (Leave blank if NONE)

Allergies/Health Concerns we should know about

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

Our Recreational Classes are Continuous AND Monthly Tuition is Pro-Rated (based on 4 weeks in a month)! Withdrawals must be emailed to explosionlloyd@gmail.com by the 20th in order for your card not to be charged for the following month.

Membership - $58 per athlete. Valid for one year. A membership is required to enroll in classes.

Memberships will be automatically collected via your credit card on the yearly anniversary of your original month's enrolment.

NSF/Declined Payments will incur a $25 Service Fee

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

Allergies/Health Concerns we should know about

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

Membership - $58 per athlete. Valid for one year. A membership is required to enroll in classes.

Memberships will be automatically collected via your credit card on the yearly anniversary of your original month's enrolment.

NSF/Declined Payments will incur a $25 Service Fee

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

Allergies/Health Concerns we should know about

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

Membership - $58 per athlete. Valid for one year. A membership is required to enroll in classes.

Memberships will be automatically collected via your credit card on the yearly anniversary of your original month's enrolment.

NSF/Declined Payments will incur a $25 Service Fee

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

Allergies/Health Concerns we should know about

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

Membership - $58 per athlete. Valid for one year. A membership is required to enroll in classes.

Memberships will be automatically collected via your credit card on the yearly anniversary of your original month's enrolment.

NSF/Declined Payments will incur a $25 Service Fee

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

Allergies/Health Concerns we should know about

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

Membership - $58 per athlete. Valid for one year. A membership is required to enroll in classes.

Memberships will be automatically collected via your credit card on the yearly anniversary of your original month's enrolment.

NSF/Declined Payments will incur a $25 Service Fee

Enroll in Classes

Select Class *

Add Another Student

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Comments

Payment Information

Please fill out ONE of the following Payment Methods

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Exp Month

Exp Year

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Name as it appears on card

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Address Line 2

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City

Province

Postal Code

eCheck/Bank Draft

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Account Type

Your Account Name (Your name on your bank statement)

Bank Transit # (5-digits)

Institution ID (3-digits)

Account Number

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)

Contact #2

How can we contact you?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

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Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

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Questions or Concerns

Payment Information

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Required Policies

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