Elevate Gymnastics Registration Form 2020-21
Student's Name *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Gender *
Parent/Guardian's First & Last Name *
Parent/Guardian's Cell # *
xxx-xxx-xxxx
Cell Provider *
Providing your cell provider allows us to automize texting. (i.e. Verizon, AT&T)
Parent/Guardian's First & Last Name
Parent/Guardian's Cell #
xxx-xxx-xxxx
Cell Provider
Providing your cell provider allows us to automize texting. (i.e. Verizon, AT&T)
Address *
Street/PO Box, City, Zip Code
Email Address *
Physical disabilities, allergies, previous injuries, etc.
Physician's Name
Physician's Telephone Number
xxx-xxx-xxxx
Emergency Contact Name *
Someone other than parent or guardian
Emergency Contact Telephone Number *
xxx-xxx-xxxx
I agree with the above Rules and Conduct of Elevate *
I agree with the scheduling and billing policies as explained *
Parent or Guardian Signature *
Typing your name constitutes a signature
Date *
MM
/
DD
/
YYYY
I would like to register for *
Required
I am interested in
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy