Gold Medal Gymnastics Online Registration

Registration

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Welcome to Gold Medal Gymnastics! Please complete the following registration form.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

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

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor*

Please click on the Search button below, then choose the class. If choosing pay in full, please allow 48 hours for the tuition to be adjusted from a four week payment to full tuition.

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

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor*

Please click on the Search button below, then choose the class. If choosing pay in full, please allow 48 hours for the tuition to be adjusted from a four week payment to full tuition.

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

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor*

Please click on the Search button below, then choose the class. If choosing pay in full, please allow 48 hours for the tuition to be adjusted from a four week payment to full tuition.

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

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor*

Please click on the Search button below, then choose the class. If choosing pay in full, please allow 48 hours for the tuition to be adjusted from a four week payment to full tuition.

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

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor*

Please click on the Search button below, then choose the class. If choosing pay in full, please allow 48 hours for the tuition to be adjusted from a four week payment to full tuition.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Assumption of Risk

I fully understand that there are risk of injury which are inherent in the sport of gymnastics. These risks include not only normal athletic strains and sprains, but also the possibility of severe injury from falls and accidents, even in the presences of due care. I, and my child, fully understand this, and understand that we are responsible for primary medical care.

I've read the above and agree.

Permission to Participate

I give my son/daughter permission to participate at Gold Medal Gymnastics. I give Gold Medal Gymnastics Staff permission to act for me according to their best judgement in any emergency requiring medical attention. I hereby waive and release Diamond Back Dave, Inc., owners, managers, and coaches from liability for any injuries while at Gold Medal Gymnastics or at any gymnastics meets, travel or parents club sponsored activities. This form is valid for any time your child participates at Gold Medal Gymnastics.

I've read the above and agree.

Payment Policies

Gold Medal Gymnastics accepts payments monthly or full session. I understand that is it my responsibility to be prompt in payments and that lack of payments may result in dismissal of my child from any class held at Gold Medal Gymnastics. Should a payment not be made according to schedule, Gold Medal Gymnastics reserves the right to charge the credit card on file.

All Team families are required to provide account information to be automatically charged monthly.

I've read the above and agree.

Photo and Website Release

I hereby authorize Gold Medal Gymnastics and Cheer to use pictures of my child taken in a photograph, digital image, videotape, motion picture, and/or testimonial (written words). The undersigned hereby releases Gold Medal Gymnastics and Cheer, its agents or employees, accountings, and causes for which the aforesaid videotape, testimonial, motion picture, digital image, or photograph likeness may be used pursuant to this Consent and General Release. It is also my understanding that I will receive not compensation for my likeness or testimonial.

I've read the above and agree.

Session Commitment Policy

I understand that I am financially committing to a 16 week session, from September 3 - December 20, 2019. Should my child decide to end the session early due to conflict or other reason, it is my parental responsibility to contact Gold Medal Gymnastics via phone or email to dismiss my child, or I will be continue to be charged for the classes my child misses during the session with no refund available.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Account Information

Payment Option*

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*