Storybook Wonder Activity Gym, LLC Online Registration

Registration

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Welcome to SWAG! Please complete the following registration form. We can't wait to see you in class.

* denotes required fields

Referral Information

How did you hear about us?

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)*

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

T-Shirt Size

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Select Class button below, then choose the class. The classes available based on your child's age will be shown.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Select Class button below, then choose the class. The classes available based on your child's age will be shown.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Select Class button below, then choose the class. The classes available based on your child's age will be shown.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Select Class button below, then choose the class. The classes available based on your child's age will be shown.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Select Class button below, then choose the class. The classes available based on your child's age will be shown.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

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

Required Policies

(Show-Hide Details)