Kidz Gym/dance Online Registration

Registration

Already a customer? Click here to login.

Welcome to Kidz Gym/dance! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Commitment/responsibilities

I understand the commitment and responsibilities of enrolling my child in classes at the above dance studio. I am aware that partaking in these classes my child may get injured due to the strenuous activity the classes require. I do not hold them liable for any doctors bills or emergency bills that I have received due to such injuries.

I've read the above and agree.

Financial obligations

I agree to fulfill my financial obligations to Kidz Gym for the current dance season. If not, I am aware that I will be charged late fees for any outstanding months. Unless the following extenuating circumstance occur; my child is unable to attend classes do to a severe injury, in which a Doctors letter will be presented. You are responsible for the entire year, even if your child loses interest in the class. Our classes are run based on your registration and our teachers are committed to the entire year for that class.

I've read the above and agree.

Right to changes of classes/Release form

Kidz Gym has the right to change your class level chosen if they feel the class is not at the appropriate age or level for your child. You will be notified by email of these changes prior to Kidz Gym making these changes. I agree to allow Kidz Gym to make the best choice for my child, based on my child's abilities.
I give permission for Kidz Gym & Dance to use any photos for all publicity deemed necessary, under the New Jersey State Laws, including their Website.

I've read the above and agree.

Payment terms

We accept Visa or Master Card. Your card will be saved for future payments. Tuition is due by the 7th of the month, our system will automatically charge your tuition on the card you saved on your parent portal between the 1st and the 7th of the month. You may change that card at any given time, but must be done PRIOR to the 1st of the month.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Account Information

Payment Plan*

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