Class Enrollment form for The Little Gym
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Student Name: *
D.O.B. *
Parent Name: *
Phone Number *
Email *
Preferred method of contact
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Registering for which class *
Day of the Week
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Time of  class
Payment Options  $95-  Every 4 weeks (monthly)                     Payment schedule will be in your emailed Welcome Folder *
By clicking below, I authorize the initial payment and all remaining scheduled payments to the credit card on file, until I provide proper two weeks notice to cancel my child's enrollment.  The $40 annual Membership fee will automatically be charged on my first payment and annually while still enrolled.   *
Please use *
If you are using a new credit card, please include swipe your card while at the gym; call in a credit card or include your information below with your credit card number; name on card; expiration date & CVC code
Please check the box to indicate you have read & reviewed our Membership Promises.
I have read & agree to TLG's promises & accept TLG's promises to me.   *
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