Elite Gymnastics, Inc.
Registration Form
Student's Name:
Age: Birthday: Grade:
Child's school:
Parent's Name:
Address:
City: Zip:
Phone (home): Driver's License #:
Work phone (mother): Work phone (father):
Cell phone: Beeper:
E-mail address:                                    Please do not e-mail: 
Day(s) and Time(s) requested:
Health Insurance: Policy #:

I hereby understand that I am responsible for the above child’s tuition which is to be paid by the 1st of each month.  If tuition is not paid by the 10th of the month,  I understand I will be assessed with a $5.00 per month late charge.  I also understand that it is my responsibility to notify Elite Gymnastics in writing if the above registered child is going to drop from the program.  If I do not do so, I will be obligated to pay monthly tuition.  I also understand there will be a $20.00 charge for any NSF checks.  I understand that if my tuition becomes more than 30 days delinquent or late, I will be obligated to pay interest on the amount outstanding or due at 18% APR.  I also understand that if Elite Gymnastics, Inc  retains an attorney to collect any past due amount that I will be obligated to pay all attorney fees and cost, including court cost incurred to collect this debt.  We, the undersigned, parents or legal guardians of the Applicant whose name appears above, recognize that there is a substantial risk of injury arising from the applicant’s participation in the programs of Elite Gymnastics, therefore in consideration of such applicant’s participation in the programs at Elite Gymnastics, hold harmless the said Elite Gymnastics, its officers, instructors, employees, and representatives from any and all liability, loss or damage, including reasonable attorney’s fees resulting from resulting claims, causes of action, demands, cost of judgments against the said Elite Gymnastics, its officers, instructors, without limitation, any injury, illness or accident, to such Applicant’s, arising from such Applicant’s participation in any way in any program, course of instruction or travel with the said Elite Gymnastics.  We further expressly give a member of the staff of Elite Gymnastics the power to consent to medical treatment during an emergency situation for health and safety of my child, in the event I/We cannot be immediately contacted. 

Date: this _____ of _______, 200__  
   

Signature of Parent / Guardian

Computer: Roster: Book:
Registration Fee: Base Charge: Prorated:
Age Group: Day: Time:
WE AT ELITE GYMNASTICS UNDERSTAND THE IMPORTANT INFLUENCE OF OUR COACHES ON YOUR CHILDREN. WE PROMISE TO RESPECT THAT INFLUENCE AND WILL DO OUR BEST TO MAKE YOUR EXPERIENCE AT ELITE AN ENJOYABLE ONE. THANK YOU FOR TRUSTING US WITH YOUR CHILDREN!

How did you hear about Elite Gymnastics:

[   ] Friend

[   ] Phone Book

[   ] Other: ______________________________