Hoosier Warriors Gym Online Registration

Registration

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Welcome to Hoosier Warriors Gym! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

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

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Please click on the Search button below, then choose the class. All of the classes are listed with a waiting list, this allows the participants to be enrolled by a Hoosier Warriors Gym staff member.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Please click on the Search button below, then choose the class. All of the classes are listed with a waiting list, this allows the participants to be enrolled by a Hoosier Warriors Gym staff member.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Please click on the Search button below, then choose the class. All of the classes are listed with a waiting list, this allows the participants to be enrolled by a Hoosier Warriors Gym staff member.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Please click on the Search button below, then choose the class. All of the classes are listed with a waiting list, this allows the participants to be enrolled by a Hoosier Warriors Gym staff member.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Please click on the Search button below, then choose the class. All of the classes are listed with a waiting list, this allows the participants to be enrolled by a Hoosier Warriors Gym staff member.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

Assumption of Risk

As the legal guardian of _____________________________________, I recognize that severe injuries, including but not limited to, concussion, permanent paralysis or death can occur in sports or activities involving height or motion, including but not limited to gymnastics, tumbling, dancing, exercise programs, trampoline, Parkour, Warriors type classes and cheerleading. Being fully aware of these dangers, I voluntarily consent to the aforementioned person to participate in any and all Hoosier Warriors Gym, LLC programs and activities and I ACCEPT ALL RISKS associated with this participation. In consideration for allowing my child to use these facilities and participate in these programs, I, on my own behalf, and of my child and our respective heirs, administrators, executors and successors, hereby forever PROMISE NOT TO SUE and FOREVER RELEASE Hoosier Warriors Gym, LLC, its officers, directors, shareholders, employees, contractors, volunteers, and all others associated with the corporation from all liability for any all damages and injuries suffered by my child while under the instruction, supervision, or control of Hoosier Warriors Gym, LLC. I am aware that individual and group publicity photos and videos are taken from time and time and in consideration for my or my child's participation I hereby grant my permission for my child's likeness to be used in Hoosier Warriors Gym, LLC publicity or advertising. In the event of an accident or emergency I hereby authorize my above-mentioned child to be transported to a hospital for medical treatment and I hold Hoosier Warriors Gym, LLC and its representatives harmless in the execution of such. Additionally, I hereby agree to individually provide for all medical expenses which may be incurred by myself or my child as a result of any injury sustained while participating at or for Hoosier Warriors Gym, LLC.

Our facility and staff are taking precautions in response to the COVID-19 concerns. In the event any members or representatives of Hoosier Warriors Gym, LLC become infected, we will cooperate with necessary organizations to provide records, contacts and accountability of all those that would be deemed essential for contact tracing.

I have read and understand this ACKNOWLEDGEMENT OF RISK and WAIVER OF LIABILITY and PHOTO RELEASE and MEDICAL AUTHORIZATION and I VOLUNTARILY affix my name in agreement.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

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

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

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)

Student #1

Enroll in Classes

Student #2 (Show-Hide Details)

Enroll in Classes

Student #3 (Show-Hide Details)

Enroll in Classes

Student #4 (Show-Hide Details)

Enroll in Classes

Student #5 (Show-Hide Details)

Enroll in Classes

Required Policies and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

Required Policies and Agreements

(Show-Hide Details)