Class Registration (all fields must be filled out) Parent or Guardian Name:* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Second Contact Information (as needed) Select Classes - Families with more than one gymnast may register multiple children for separate classes on one form.* Gym Tots Gym Bees Bumble Bees Super Bees Gym Midjies 1 Gym Midjies 2 Recreational Xcel High School Off Season Gym Tots Gymnast Name* First Last Gym Tots Gymnast Birthdate* Month Day Year Gym Bees Gymnast Name* First Last Gym Bees Gymnast Birthdate* Month Day Year Gym Bees Lessons*8 Lessons12 Lessons16 LessonsBumble Bees Gymnast Name* First Last Bumble Bees Gymnast Birthdate* Month Day Year Bumble Bees Lessons*8 Lessons12 Lessons16 LessonsSuper Bees Gymnast Name* First Last Super Bees Gymnast Birthdate* Month Day Year Super Bees Lessons*8 Lessons12 Lessons16 LessonsGym Midjies 1 Gymnast Name* First Last Gym Midjies 1 Gymnast Birthdate* Month Day Year Gym Midjies 1 Lessons*8 Lessons12 Lessons16 LessonsGym Midjies 2 Gymnast Name* First Last Gym Midjies 2 Gymnast Birthdate* Month Day Year Gym Midjies 2 Lessons*8 Lessons12 Lessons16 LessonsRecreational Xcel Gymnast Name* First Last Recreational Xcel Gymnast Birthdate* Month Day Year High School Gymnast Name* First Last High School Gymnast Birthdate* Month Day Year High School Off Season Months* Select All June July August May we have permission to use your child(rens)’s image in publicity online (social media and website) and in print?* Yes No Please read and accept the Assumption of Risk form.I have read and accept the Assumption of Risk* Accept Is there anything we need to know about your child(ren)?Other comments:
