Registration


Welcome to Glitch Fitness! We are so excited to have you join our fitness family! Please complete the registration form below. Additional classes and/or additional children can be added to this form, if needed. Please feel free to call or text if you have any questions at (702) 981-8737 or email us at Info@Glitchfitness.com.

*   denotes required fields

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

Instructions

Select class for student #1 before adding additional students

To select a class or add additional class select blue "Select Class" button

To add additional child select "Add Another Student"

We will reach out to you upon submission to confirm all details.

Enroll in Classes
Select Class
Required Policies
 (Show-Hide Details)
Questions or Concerns
Payment Information
Account Information
Credit Card
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