CHILD’S FIRST & LAST NAME:_______________________________ PARENT’S NAME ______________________
ADDRESS:______________________________________________CITY:_____________________
ZIP:___________
CHILD’S BIRTH
DATE_________________________ HOME #_______________________________
EMERGENCY CONTACT NAME &
#:____________________________________ CELL #_____________________
DOCTORS NAME & #_____________________________________________ WHERE DID YOU HEAR ABOUT US?________________________________
PLEASE LIST ANY MEDICAL OR
OTHER INFORMATION PERTAINING TO YOUR CHILD’S ABILITY TO PARTICIPATE IN
GYMNASTICS: (HEART CONDITION,ASTHMA,BRONCHITIS,ORTHOPEDIC/BACK/NECK PROBLEMS,
ETC.):______________________________________________________________________________
I AM REGISTERING MY
DAUGHTER/SON IN ALL STARS GYMNASTICS PROGRAM , WHO IS IN EXCELLENT HEALTH AND
IS ABLE TO PARTICIPATE IN GYMNASTICS, WHICH WE ACKNOWLEDGE IS A PHYSICALLY
CHALLENGING AND POTENTIALLY DANGEROUS SPORT; ACCORDINGLY I ASSUME THE RISK OF
MY CHILD’S PARTICIPATION. MY CHILD HAS
PERSONAL MEDICAL INSURANCE AND HAS HAD A PHYSICAL EXAMINATION BY A DOCTOR
WITHIN THE LAST SIX MONTHS. I AM IN
AGREEMENT WITH AND WILL ABIDE BY ALL SCHOOL POLICIES AND GYMNASTICS RULES.
FALL/SPRING REGISTRATION POLICY: AT
TIME OF REGISTRATION A THIRD OF TUITION IS REQUIRED TO RESERVE YOUR CHILD’S
PLACE. THE BALANCE IS THEN BROKEN INTO
TWO PAYMENTS, WHICH ARE DUE BY THE 1ST
& 3RD CLASS.
SUMMER REGISTRATION POLICY: AT THE TIME OF REGISTRATION ˝ THE TUITION IS DUE TO RESERVE YOUR CHILDS PLACE.THE BALANCE IS
DUE ON OR BEFORE OUR SUMMER SEMESTER BEGINS.
REGISTRATION /INSURANCE FEE: $30 (PAYABLE ONCE A YEAR): EVERY PARTICIPANT MUST PAY THIS FEE AT TIME OF REGISTRATION.
REFUND POLICY: $75 OF THE TUITION IS NON-REFUNDABLE AT
TIME OF REGISTRATION, ABSOLUTELY NO EXCEPTIONS.
EACH GYMNAST HAS UP UNTIL
THEIR THIRD CLASS TO DECIDE IF THEY WISH TO WITHDRAW FROM THE PROGRAM. AT THIS TIME TUITION LESS $75 WILL BE
REIMBURSED. THERE WILL BE ABSOLUTELY NO
REFUNDS AFTER THE 3RD CLASS OF THE SEMESTER.
__________________________________________ ______________________
PARENT’S SIGNATURE TODAY’S
DATE
CLASS:
___________________
DAY:____________TIME:_______________TUITION:_____________________
REGISTRATION/INSURANCE FEE
:$30 TOTAL:_________CHECK#________AMOUNT________DATE______
NOTE:__________________________________________________________________________________________
CLASS:
_____________________ DAY:_____________TIME:___________________TUITION:_______________
REGISTRATION/INSURANCE FEE
:$30 TOTAL:__________CHECK#_________AMOUNT:_______DATE____
NOTE:__________________________________________________________________________________________
CLASS:
_____________________ DAY:_____________TIME:___________________TUITION:_______________
REGISTRATION/INSURANCE FEE
:$30 TOTAL:__________CHECK#_________AMOUNT:_______DATE____
NOTE:__________________________________________________________________________________________