2011-12 Knightdale Gymnastics

Class Registration Form

* First Name

* Last Name

* Birthdate

First Name

Last Name

Birthdate

First Name

Last Name

Birthdate

* Have the above gymnast(s) ever been seriously injured?

If yes, please describe.

Mother's name

Father's name

Work Phone

Cell Phone

* Address

* City

* State

* Zip

* Home Phone

E-mail address

* Emergency contact - other than parents

* Phone

Please select the class(es) in which you wish to enroll. Put a 1 in the block for each class or 2 if you are enrolling two children for the same class. Don't forget to include your registration fee (single child or family). Your total due on the first class will be displayed on the next page after clicking "Continue" at the bottom of the page.

	Single child registration fee
	Family registration fee
	Parent-tot - Thursday 6:00-6:30
	Tiny tots - Tuesday 6:00-6:45
	Tiny-tots - Thursday 6:00-6:45
	Tiny tots - Wednesday 2:00-2:45
	Tiny Tots Wednesday 6:00-6:45
	Tumble bears - Tuesday 6:00-7:25
	Tumble bears - Thursday 6:00-7:25
	Tumble bears - Wednesday 2:00-3:25
	Tumble bears - Wednesday 6:00-7:25
	Dancenastics - Tuesday 6:00-7:25
	Dancenastics - Thursday 6:30-7:55
	Fun&Fit - Monday 5:30-6:25
	Progressive 1 -Monday 5:30-7:25
	Progressive 1 - Wednesday 5:30-7:25
	Progressive 2 (must have completed Progressive 1) - Tuesday 5:30-7:25
	Tumble/Cheer (ages 6-10) - Monday 6:30-7:25
	Tumble/Cheer (ages 11+) - Monday 7:30-8:25
	High School Gymnastics Monday 6:00-7:30
	High School Gymnastics Wednesday 6:00-7:30

COUPON CODES:
Type "SCD" if you chose more than one class for ONE child ($10.00 discount)
Type "sibling" if you registered TWO children for one class each ($10.00 discount)
Type "family" if you registered MORE than two children ($20.00 discount)

Like any physical activity, participation in gymnastics does involve a certain amount of risk of injury. By permitting this child to participate (or by my participation) in the Knightdale Academy of Gymnastics instructional program I do hereby release Knightdale Academy of Gymnastics, its owners and eployees, jointly and severally from all claims, demands, rights and causes of action of whatever kind and nature arising through or from participation in activities as a student of the Knightdale Academy of Gymnastics.

Agree

Tuition is due on the 1st of each month. After the 7th of the month a $10.00 late fee will be added to your account.

All returned checks will be subject to a $30.00 service charge.

To terminate this payment contract with Knightdale Academy of Gymnastics, WRITTEN NOTIFICATION is required 15 days before the first scheduled lesson of the next month.

Agree

* Please select the date you would like to begin

* Indicates Response Required

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2011-12 Knightdale Gymnastics Class Registration Form

2011-12 Knightdale Gymnastics

Class Registration Form