New Customer Registration Form

Jewart's Gymnastics NW:

REGISTRATION FORM
Student Info
Student's Name *

First Name Last Name
Sex *
Student Birthday *

Month Day Year
Date
Any known medical or developmental conditions? *
Family Information
Parent Name *

First Name Last Name
Second Parent Name

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Primary Number *

Area Code Phone Number
Alt Number

Area Code Phone Number
E-mail *
example@example.com
E-mail
Emergency Contact *

First Name Last Name
Emergency # *

Area Code Phone Number
How did you hear about us? *
If by word of mouth please share from whom.
Other *
Gymnastics Class Preference
I would like to register my child for this class: *
see class descriptions on our website for information about best fit for your child
Preferred Day for class *
see class schedule on our website for options
Preferred Time for class *
see class schedule on our website for options
Need to Know

Most important Rules & Policies - By choosing 'I agree' below, you agree to adhere and follow JGNW's rules and policies (see full document on website for all other rules and policies).
All payments are due prior to the beginning of the first class of each month. To help us eliminate costs for billing we prefer you choose our automated funds transfer. For security, all numbers are encrypted and only enter the system when your card is swiped. You must notify us if you drop or we continue billing without refund. *
If you join in the middle of the month tuition is pro-rated accordingly. If you join past half way through the month you need to register for the current month and the following month. *
All current members must have an active credit or debit card on file. You do not have to pay with this option, but it must be on file and up to date. *
If you are past 2 weeks late on tuition your credit card on file on file will automatically be charged without notice or refund. *
You must submit in written notice any child’s drop from class for any reason. Understand that if notice is not received, the credit card on file will be charged without refund until notice is received. *
JGNW closes for all major holiday’s without make up class options. Major holidays include (New Year’s Eve,New Year’s Day, Easter, Memorial Day, Independence Day, Labor Day, Halloween, Thanksgiving, Christmas Eve, and Christmas Day). *
Children may do one make up class per month for any reason. Gym/Program Directors must be notified and class scheduled oneweek before any make- up is attended. Make up classes do not add up from month to month. *
Pictures/Videos of your child may be taken during class or events and may be used on our website or facebook page for the intention of supporting/promoting JGNW. *
- We offer a 10% discount on the lowest tuition if 2 or more children register for classes.
- Discount for multiple team kids is 5%.
- Registration fees or event fees are not discounted and not refundable.
- Refunds are given for the remaining classes only if you are a first-time customer and are not satisfied after the first month.
Finalizing your Registration

Steps to Take
This online form is just for collecting beginning information from new clients, there are several other needed steps before your child's registration for gymnastics is complete.

Next, call JGNW at 503-482-5776 and speak to the staff in order to complete your registration.

Prior to attending class you will need to:
1. Speak to JGNW staff on the phone or in person to ensure we have received your registration.
2. Make a payment over the phone or in person.
3. Confirm class placement and start date with JGNW staff.
Waiver of Claims, Release of Liability, Assumption of Risk and Indemnity Agreement

This form must be signed by a parent or legal guardian and the child if over 7 years of age.
By signing this document you will waive certain legal rights including the right to sue or claim compensation following an accident, injury or death. Please read carefully. My child has permission to attend classes at Jewart’s Gymnastics NW. I feel my child is mentally and physically capable to follow directions and participate in a program that offers gymnastics, tumbling, and T and T. I understand that my child will use trampolines and other apparatus involving height and motion, which might increase 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 NW 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 agree to waive any and all claims resulting from such damage, loss or injury and this release shall be effective and binding. I have thoroughly read this acknowledgement of risk and liability. I UNDERSTAND AND ACCEPT THE CONTENT and INTENT OF THIS DOCUMENT TO FULLY ASSUME ALL RISK and WE WILL NOT PURSUE LEGAL REMEDY FOR INJURY OR LOSS. WE VOLUNTARILY SIGN IN ACCEPTANCE.

*I HAVE EXPLAINED THIS WAIVER TO MY CHILD
Parent Signature

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Jewart's Gymnastics NW:

Student Info

Family Information

Gymnastics Class Preference

Need to Know

Finalizing your Registration

Waiver of Claims, Release of Liability, Assumption of Risk and Indemnity Agreement