South Bay Divas Online Registration

Registration

SBD Registration

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Assumption of Risk

I understand the risk involved with any activity involving motion, height, athletic activity, and/or gymnastic or sports equipment creates the possibility of serious injury, including death. I assume all risks of such injury and agree to hold SBD and its parties harmless for any injury or resulting expenses.

I've read the above and agree.

Release of Liability

SBD strives to provide the maximum in safety procedures, guidelines, and enforcement, and therefore assumes no responsibility for any accidents or injuries that may occur. I am fully aware that any activity involving motion, height, athletic activity, and/or gymnastic equipment (ie Tumbl-Trak®, Air-track, Rock Wall, Rope, Skill shapes, etc) creates the possibility of serious injury, and I further agree to hold SBD and its staff and officers harmless for any injury or resulting expenses. I release and discharge all rights and claims against SBD and its parties.

I've read the above and agree.

Medical Emergencies

For minor injuries, SBD policy is to call the parent/guardian listed on registration, inform them, and follow their directions. In the rare case of a more serious injury, SBD policy is to first call 911, then call the parent/guardian listed on registration. I authorize SBD and its representatives to consent to medical treatment for my child when I cannot be reached to so consent. I also give SBD permission to administer the necessary emergency care to my child to stabilize and/or improve the current injury or condition that my child may have sustained during activities related to SBD instruction, practices, or performances. No prior determination to life threatening emergency or danger of serious or permanent injury resulting from treatment need be made under this authorization.

I've read the above and agree.

Payment Policies

Credit card is charged at time of purchase. Money-back guarantee: We are so confident that your child will love our program, we guarantee it! In the event he/she attends their first class and it's not the right fit, we will refund the remaining amount of the trial offer, minus the first class.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*