Elevate Aerial Studio Online Registration

Registration

Already a customer? Click here to login.

Welcome! Please read the following to complete our registration form.

New Adult students (18+): Fill out all info (including Contact #1 & Student sections) as yourself.

New Kids/Teens: Parents must fill out the form. Fill out Contact #1 section as yourself (the parent/guardian). Then, fill out the Student section with your child's name and information that will be attending class.

Once complete, it will create your Jackrabbit portal.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Information

Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact ( Name & Phone Number )*

Health Insurance Carrier*

Contact #1

Main contact - First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Elevate Aerial Studio. Standard message and data rates apply. Reply STOP to opt out

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Birth Date*

Additional Info

School*

Grade Level

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

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*

Birth Date*

Additional Info

School*

Grade Level

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

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*

Birth Date*

Additional Info

School*

Grade Level

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

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*

Birth Date*

Additional Info

School*

Grade Level

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

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*

Birth Date*

Additional Info

School*

Grade Level

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

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

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

Membership Type*

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

Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

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

Account Information

Credit Card

Required Policies

(Show-Hide Details)