Registration


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Premier Gymnastics Academy Registration and Release Form **IF YOU DO NOT WANT YOUR PAYMENTS DRAFTED OUT ON A REGULAR BASIS PLEASE DO NOT SELECT AN E-PAYMENT SCHEDULE AT THE END OF THIS FORM**

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Referral Information
Family Information
Where do you live?
Click to Enter an International Number
Additional Info
Contact #1
How Can We Contact You?
Click to Enter an International Number
Click to Enter an International Number
Click to Enter an International Number
Portal Access (your email is your login)
(Emails are kept confidential)
Who is your employer?
Click to Enter an International Number
Contact #2
How can we contact you?
Click to Enter an International Number
Click to Enter an International Number
Click to Enter an International Number
(Emails are kept confidential)
Who is your employer?
Click to Enter an International Number
Student #1
(format=mm/dd/yyyy)
Additional Info

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Required Policies and Agreements
I Agree to All of the Above
Questions or Concerns
Payment Information
Account Information
Credit Card