2011 Registration || 2011-12 Fall Classes

Fall Registration

Click here to view printable registration form and fax to 412-487-7333 or use our

ONLINE REGISTRATION FORM 2011-2012

* NOTE: Please check our schedule page for filled classes

Student Information: All Blanks With A ( * ) Are Required

Name *

Sex *

Date of Birth *

Age *

Grade *

Address: *

City: *

State: *

Zip *

Email *

Home Phone: *

Emergency Phone # : *

Please list any medical conditions to which we should be alerted if none type n/a *

Mom's Name: *

Place of Business: *

Occupation: *

Dad's Name: *

Place of Business: *

Occupation: *

How did you learn about Jewart's Gymnastics?

If by a Friend or Other, please specify:

Have you had any other children enrolled at Jewart's?

WAIVER OF LIAIBILITY: This form must be signed by a parent or guardian and the child if over 7 years of age. My child has permission to attend classes at Jewart's Gymnastics. I feel my child is mentally and physically capable to participate in a program that offers either gymnastics, tumbling or rhythmic. I understand that my child will use trampolines and other apparatus involving height and motion, which might increases the inherent risk of these activities. I understand that these activities could lead to catastrophic injuries or even death. I hereby release Jewart's Gymnastics and it's owners, landlords, officers, employees, teachers and coaches from all liability for any and all damages, loss and injuries suffered by my child or me while in the facility as a student, participant or spectator. I have thoroughly read this acknowledgement of risk and liability. I UNDERSTAND AND ACCEPT THE CONTENT AND INTENT OF THIS DOCUMENT AND VOLUNTARILY SIGN IN ACCEPTANCE. I have explained the contents of this waiver to my child.

Please type your child's full name and the date here: *

Please type your full name and the date here: *

Total Amount Due: *

CLASS & PAYMENT INFORMATION:

My child is enrolled in the following class or team program:

Class Day / Time, or Team Name:

ADDITIONAL CLASSES:

My child is also enrolled in the following class or team program:

Class Day / Time, or Team Name:

All payments are due prior to the beginning of the first class of each session. To help us eliminate costs for billing and late payments, we prefer you choose our automated funds transfer or late fee option. For you security, all numbers are encrypted and only enter the system when your card is swiped. Unless using auto-pay your tuition is due the 15th of the month prior to the first class of September, November, January and March session.

My payment method will be: Auto-Pay Credit or Debit System. Payments are drafted the 1st of the month for bi-monthly sessions and team tuition.
Bi-monthly check / cash. 2 month payments must be received in the office before the first class of the session.
9 Month Cash Up Front. 3% discount for Sept thru May only. A one time payment is due on or before the first class in September.
Late charge authorization. Jewart's may charge my card if payment is not received by the first class of the session. Sign up in the office.
Monthly payments are for team only. Payment must be made by the 1st of the month or we can charge your credit card. Please leave a credit card number with the office and fill in the consent to use this option or use AFT. A $10 late fee will be assessed
Check here to receive e-mail billing instead of mail.

Registration fee of $40 + Tuition Payment may be:

Dropped off at the gym office, 2468 Wildwood Rd. (near North Park)

Mailed to: Jewart's Gymnastics, P. O. Box 36 Wildwood, PA 15091

Faxed to 412-487-7333 *

* Make your payment in the office if you choose this option. 412-487-5999.

** Please Note **

By Clicking submit below you understand that you have read and agree to the policies and waiver of liability.

We offer a 10% discount on the lower tuition if 2 or more children register for classes. If you sign up for two regular classes you receive a 15% discount on lower class tuition. 5% discount for multiple team tuition. Registration fees are not discounted, nor refundable. Refunds are given for the remaining classes only if you are a first-time customer and are not satisfied after the first session.

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Be Sure To Fill in All Fields That Have a (*) Or The Form Won't Submit

Fall Registration

CLASS & PAYMENT INFORMATION:

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