Nasser Gymnastics Academy Online Registration

Registration

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We're excited to get your child started at Nasser Gymnastics Academy! Complete this form and we'll EMAIL you confirmation, information, and next steps. RESPONSE IS REQUIRED TO COMPLETE ENROLLMENT. NEW GYMNASTS ages 3-8 start in a 1-month beginner class. *By submitting this form, you are OPTING IN to receive texts, emails, and our newsletter & you AGREE TO allow us to auto charge you for the non-refundable $45 annual membership fee.

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Referral Information

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Referral Name

Family Information

STUDENT'S LAST NAME Last Name*

Where do you live?

Home Address*

City*

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Zip*

Primary Phone*

Contact #1

Parent/Guardian #1 First Name*

Last Name *

Type*

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Cell # *

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Portal Access (your email is your login)

Email* (Emails are kept confidential)

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Contact #2

Parent/Guardian #2 First Name*

Last Name*

Type*

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Cell # * Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Nasser Gymnastics Academy. Standard message and data rates apply. Reply STOP to opt out

Email* (Emails are kept confidential)

Confirm Email*

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Disabilities (Leave blank if NONE)*

Special Needs (Leave blank if NONE)*

Interested in Classes (Y/N)*

Interested in Private Less. YN*

Interested in Clinics (Y/N)*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Disabilities (Leave blank if NONE)*

Special Needs (Leave blank if NONE)*

Interested in Classes (Y/N)*

Interested in Private Less. YN*

Interested in Clinics (Y/N)*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Disabilities (Leave blank if NONE)*

Special Needs (Leave blank if NONE)*

Interested in Classes (Y/N)*

Interested in Private Less. YN*

Interested in Clinics (Y/N)*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Disabilities (Leave blank if NONE)*

Special Needs (Leave blank if NONE)*

Interested in Classes (Y/N)*

Interested in Private Less. YN*

Interested in Clinics (Y/N)*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Disabilities (Leave blank if NONE)*

Special Needs (Leave blank if NONE)*

Interested in Classes (Y/N)*

Interested in Private Less. YN*

Interested in Clinics (Y/N)*

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Comments

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e-Payment Schedule*

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

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Student #2 (Show-Hide Details)

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Student #3 (Show-Hide Details)

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