CheerPro Training LLC Online Registration

Registration

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Welcome to CheerPro Training! 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*

Primary Phone*

Additional Info

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

Health Insurance Carrier*

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*

Cell #*

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enrollment now is OPTIONAL (bypass the blue button). You may enroll after registration is complete by:

1). Submitting your registration form (click 'SUBMIT REGISTRATION' at the bottom of this form).

2). Log into your NEW CheerPro Account.

3). Click > FIND CLASSES and for private lessons Click > FIND EVENTS.

4). Please be sure to complete CHECKOUT and that you receive email confirmations for each of your enrollments.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enrollment now is OPTIONAL (bypass the blue button). You may enroll after registration is complete by:

1). Submitting your registration form (click 'SUBMIT REGISTRATION' at the bottom of this form).

2). Log into your NEW CheerPro Account.

3). Click > FIND CLASSES and for private lessons Click > FIND EVENTS.

4). Please be sure to complete CHECKOUT and that you receive email confirmations for each of your enrollments.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enrollment now is OPTIONAL (bypass the blue button). You may enroll after registration is complete by:

1). Submitting your registration form (click 'SUBMIT REGISTRATION' at the bottom of this form).

2). Log into your NEW CheerPro Account.

3). Click > FIND CLASSES and for private lessons Click > FIND EVENTS.

4). Please be sure to complete CHECKOUT and that you receive email confirmations for each of your enrollments.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enrollment now is OPTIONAL (bypass the blue button). You may enroll after registration is complete by:

1). Submitting your registration form (click 'SUBMIT REGISTRATION' at the bottom of this form).

2). Log into your NEW CheerPro Account.

3). Click > FIND CLASSES and for private lessons Click > FIND EVENTS.

4). Please be sure to complete CHECKOUT and that you receive email confirmations for each of your enrollments.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enrollment now is OPTIONAL (bypass the blue button). You may enroll after registration is complete by:

1). Submitting your registration form (click 'SUBMIT REGISTRATION' at the bottom of this form).

2). Log into your NEW CheerPro Account.

3). Click > FIND CLASSES and for private lessons Click > FIND EVENTS.

4). Please be sure to complete CHECKOUT and that you receive email confirmations for each of your enrollments.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

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)

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

eCheck/Bank Draft

Required Policies

(Show-Hide Details)