River Run Gymnastics Academy Online Registration

Registration

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Welcome to River Run Gymnastics Academy! Please complete the following registration form.

**All summer payments will be withdrawn from your preferred payment method on June 20, 2025.**

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Referral Information

How did you hear about us?

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info<br/>(Not Contact #1 or #2)name and phone number*

Health Insurance Carrier*

Enter Coupon Code

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 #

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Injuries/chromic ailments (Leave blank if NONE)

Disabilities (Leave blank if NONE)

Any other problem areas or anything we should know (fears, ADHD etc.)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor Name & Phone number*

Photo/video release? (Yes/No)*

Enrolled in previous session? *

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*

Additional Info

Injuries/chromic ailments (Leave blank if NONE)

Disabilities (Leave blank if NONE)

Any other problem areas or anything we should know (fears, ADHD etc.)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor Name & Phone number*

Photo/video release? (Yes/No)*

Enrolled in previous session? *

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*

Additional Info

Injuries/chromic ailments (Leave blank if NONE)

Disabilities (Leave blank if NONE)

Any other problem areas or anything we should know (fears, ADHD etc.)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor Name & Phone number*

Photo/video release? (Yes/No)*

Enrolled in previous session? *

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*

Additional Info

Injuries/chromic ailments (Leave blank if NONE)

Disabilities (Leave blank if NONE)

Any other problem areas or anything we should know (fears, ADHD etc.)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor Name & Phone number*

Photo/video release? (Yes/No)*

Enrolled in previous session? *

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*

Additional Info

Injuries/chromic ailments (Leave blank if NONE)

Disabilities (Leave blank if NONE)

Any other problem areas or anything we should know (fears, ADHD etc.)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor Name & Phone number*

Photo/video release? (Yes/No)*

Enrolled in previous session? *

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

Enroll in Classes

Select Class *

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

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*

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

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

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I Agree to All of the Above

Questions or Concerns

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Account Information

Credit Card

Required Policies

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