Elevate Gymnastics Academy Online Registration

Registration

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Welcome to Elevate Gymnastics Academy! We offer Gymnastics classes as well as Ninja Zone Classes. Please complete the registration form below and review the classes we offer by clicking on SELECT CLASS beneath the ENROLL IN CLASSES heading. You may then place yourself on a waiting list or schedule a Trial class (if available).

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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 Name and Phone # (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*

Additional Info

Special Needs (Leave blank if NONE)

PLEASE CLICK ON THE SELECT CLASS TAB TO PLACE YOURSELF ON A WAITING LIST OR SCHEDULE A TRIAL (IF AVAILABLE). TRIAL CLASSES ARE OFFERED TO NEW STUDENTS OR TO RETURNING STUDENTS THAT HAVE BEEN GONE FOR 6 MONTHS OR LONGER

PLEASE DO NOT MAKE A PAYMENT ON THE ACCOUNT UNTIL YOU HAVE DONE YOUR TRIAL CLASS

PAYMENT IS DUE THE DAY OF YOUR FREE TRIAL AFTER THE TRIAL CLASS HAS BEEN COMPLETED.

YOU MAY NOT PLACE YOURSELF ON MORE THAN 2 WAITING LISTS.

ONLY ONE TRIAL CLASS IS ALLOWED. PLEASE ONLY SELECT A CLASS FOR A TRIAL IF YOU CAN COMMIT TO THIS DAY AND TIME.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

PLEASE DO NOT MAKE A PAYMENT ON THE ACCOUNT UNTIL YOU HAVE DONE YOUR TRIAL CLASS

PAYMENT IS DUE THE DAY OF YOUR FREE TRIAL AFTER THE TRIAL CLASS HAS BEEN COMPLETED.

YOU MAY NOT PLACE YOURSELF ON MORE THAN 2 WAITING LISTS.

ONLY ONE TRIAL CLASS IS ALLOWED. PLEASE ONLY SELECT A CLASS FOR A TRIAL IF YOU CAN COMMIT TO THIS DAY AND TIME.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

PLEASE DO NOT MAKE A PAYMENT ON THE ACCOUNT UNTIL YOU HAVE DONE YOUR TRIAL CLASS

PAYMENT IS DUE THE DAY OF YOUR FREE TRIAL AFTER THE TRIAL CLASS HAS BEEN COMPLETED.

YOU MAY NOT PLACE YOURSELF ON MORE THAN 2 WAITING LISTS.

ONLY ONE TRIAL CLASS IS ALLOWED. PLEASE ONLY SELECT A CLASS FOR A TRIAL IF YOU CAN COMMIT TO THIS DAY AND TIME.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

PLEASE DO NOT MAKE A PAYMENT ON THE ACCOUNT UNTIL YOU HAVE DONE YOUR TRIAL CLASS

PAYMENT IS DUE THE DAY OF YOUR FREE TRIAL AFTER THE TRIAL CLASS HAS BEEN COMPLETED.

YOU MAY NOT PLACE YOURSELF ON MORE THAN 2 WAITING LISTS.

ONLY ONE TRIAL CLASS IS ALLOWED. PLEASE ONLY SELECT A CLASS FOR A TRIAL IF YOU CAN COMMIT TO THIS DAY AND TIME.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

PLEASE DO NOT MAKE A PAYMENT ON THE ACCOUNT UNTIL YOU HAVE DONE YOUR TRIAL CLASS

PAYMENT IS DUE THE DAY OF YOUR FREE TRIAL AFTER THE TRIAL CLASS HAS BEEN COMPLETED.

YOU MAY NOT PLACE YOURSELF ON MORE THAN 2 WAITING LISTS.

ONLY ONE TRIAL CLASS IS ALLOWED. PLEASE ONLY SELECT A CLASS FOR A TRIAL IF YOU CAN COMMIT TO THIS DAY AND TIME.

Enroll in Classes

Select Class *

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

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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

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Questions or Concerns

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