Tiny Tumblers FALL 2021 GYM Registration Form
Registration for GYM at 146 S. Peaceful Court, Cedar City, UT 84720.
Email address *
Athlete Name (nickname) & Last Name
Athlete Age/Gender
Guardian Name (first & last)
Guardian Contact # (EX: 801-787-7510)
2nd Contact Phone # (Transportation Individual & Relation to Athlete (ex: 435-218-8313, Kari, parent)
Prices: MONTHLY tuition payment incurs a $2/mo processing fee, OR pay by SEMESTER (from YOUR start date). *
Class Preference (In Order By AVAILABILITY) *
**Click the preferred class(es) that apply to the athlete.*WINTER SEMESTER runs from January through April. Tuition is pro-rated from your start date. Our TRADITIONAL class sizes are: (Preschool= 4-6 athletes for 2-4yr olds, 8-10 athletes for 4-6yr olds with 1-2 coaches, ALL others classes= up to 12 athletes w/ 2 coaches).
Athlete Full Birthdate (Ex: 08/21/11) *
$5 Referral Bonus. List the name of the friend that referred YOU!
How did you hear about Tiny Tumblers Gym?! *
Clear selection
Liability & Medical Disclaimer
I realize that the activity for which I/my athlete is engaging involves a certain amount of risk and hereby agree to assume all such risk of myself/my athlete while participating in such activity. I certify that I have PROOF OF MEDICAL COVERAGE for my athlete/self and will cover all medical bills in the event of any injury, either while the coach is watching/spotting, or while attempting skills solo. I agree to release and indemnify Tiny Tumblers Gym, Kari Louthan, or any other agents and employees from any and all such claims due to loss, damage, or injury sustained by me/my athlete at the 146 S. Peaceful Court premises.

I understand that pictures and/or videos may be publicly posted of me/my child for marketing purposes of Tiny Tumblers Gym, unless written notification is made to withhold pictures/videos. Additionally, I will provide Tiny Tumblers Gym email written notification ONE MONTH PRIOR TO TERMINATION OF SERVICES, or will agree to pay one month’s tuition for failure to notify in advance. I understand that by choosing YES below, I am legally bound to the terms and conditions set in this liability and medical disclaimer.
Liability & Medical Disclaimer *
Payment Method (SEMESTER TUITION PREFERRED, or Monthly payments by the 20th of each month, for future services). *
NAME of Medical/Health Provider, Coverage, OR $20 non-refundable charge/semester for NONE. (ex: none, Bluecross/Blueshield). *
HealthCare Provider Plan # (or Member/Group ID) *
Registration Reminders
*Class sizes may be smaller during some COVID periods, but may pick up to regular speed at some point in time throughout the year. Extra safety measures being made include athlete hand washing/gym cleaning, hand/door rails sanitization, a thermometer for temperature readings, and the wearing of masks when desired or necessary.

*Please wear tight flexible, or athletic attire. Have hair pulled back & out of face, and bring a water bottle (labeled with last name). We prefer cul-de-sac usage for athlete pick-up by our large rock near driveway. Please AVOID BLOCKING the "hidden driveway" on the RIGHT SIDE as you enter the cul-de-sac, & ALL neighboring driveways. Park in my driveway for emergencies. Please park perpendicular to the circular curb, (i.e. park head on at the home NOT parallel) as there is limited parking space (2 spots only).

*Entrance is located at the door to the RIGHT side of the garage door. Please remove shoes and jackets on the hooks provided along the wall path. *WASH HANDS IN GARAGE SINK,* then head inside and directly down the spiral staircase to the GYM facility. Arrive 5 minutes EARLY to allow for hand washing and shoe/jacket/snow removal.

*The preferred method for all payments is Venmo, @tinytumblersgym. All CASH received will be confirmed via email: mytinytumblersgym@gmail.com. We have limited seats available for viewing purposes. You are welcome to stay with your athlete whenever, but are not expected to stay for the 45min+ classes.

*We require a 1-month written notice of cancellation or customer agrees to pay for that month of tuition.*
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