Mary Jane's Gymnastics - Corpus Christi, LLC Online Registration

Registration

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Welcome to Mary Jane's Gymnastics @ Corpus Christi location! Please complete the following registration form and pick your classes. We look forward to having you be a part of our family and coaching your athlete! If you are a returning family, you already have an account. Please click the link above and log in with your email and set up a password. If you are new to Mary Jane's Gymnastics, please fill out the form below and follow prompts.

* denotes required fields

Referral Information

How did you hear about us?*

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

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?

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Class will start and end in the parent observation room area

Students are required to have their hair up and out of their face.

No Jewelry

No Socks/Shoes

Bring a water bottle (all drinks must have a covered top/no sodas in gym area)

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Class will start and end in the parent observation room area

Students are required to have their hair up and out of their face.

No Jewelry

No Socks/Shoes

Bring a water bottle (all drinks must have a covered top/no sodas in gym area)

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Class will start and end in the parent observation room area

Students are required to have their hair up and out of their face.

No Jewelry

No Socks/Shoes

Bring a water bottle (all drinks must have a covered top/no sodas in gym area)

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Class will start and end in the parent observation room area

Students are required to have their hair up and out of their face.

No Jewelry

No Socks/Shoes

Bring a water bottle (all drinks must have a covered top/no sodas in gym area)

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Class will start and end in the parent observation room area

Students are required to have their hair up and out of their face.

No Jewelry

No Socks/Shoes

Bring a water bottle (all drinks must have a covered top/no sodas in gym area)

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

Zip*

Registration

Referral Information

Family Information

Where do you live?

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

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