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Wednesday, May 24, 2017 11:56 PM



Gymnastics Registration Form
Semester Date: Day and Time of Class:
Child's First and Last Name: Child's DOB:
Child's Age: Child's Gender:
Daytime Phone: Street Address:
City, State: Zip Code:
Mother/Guardian Name: Mother/Guardian Number:
Father/Guardian Name: Father/Guardian Number:
Emergency Contact Name: Relationship:
Contact Number 1: Contact Number 2
Family Physician: Phone Number:
Insurance Company: ID Number:
Medical conditions we should be aware of:
Is your child currently enrolled in our program? If so, which one?
How did you hear about our program?
Do you permit Bayou Gymnastics to photograph/videotape your child for promotional use? Yes    No
Have you called about openings in the preferred class? Yes    No
I have read and agree to the Waiver and Release of Liability.
I agree that I have completed the above information, and it is true to the best of my knowledge. I have also read and fully understand the Waiver and Release of Liability and realize by typing my name and date in the boxes below, I have verified this information and am digitally signing this form.
Electronic Signature: Date:

Completing this form DOES NOT guarantee your spot in the class of your choice.


*TUITION IS DUE PRIOR TO THE 1ST OF EACH MONTH
*REGISTRATION FEES ARE NON-REFUNDABLE

Payment Options
We accept Cash, Checks, and Visa, MasterCard and Discover (Credit and Debit)
  • You may pay monthly or for the entire semester
  • Make checks payable to: Bayou Gymnastics
  • On check, include: Child's Name, Class Day & Class Time
  • $25.00 Service Charge for all returned check





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