NS Strides Spring Registration

8-week Spring Fitness Session

Sessions are on Tuesdays at 10:30am, 3/12/24 - 5/7/24 (no session 4/2/24 for Spring Break)
Parent/Guardian Info
Name*

First NameLast Name
e-mail*
example@example.com
Primary Phone*
Work Phone
Cell Phone
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact (If Parent/Guardian cannot be reached)*
Relationship to Student*
Emergency Phone*
Student Info
Student Name*

First NameLast Name
Date of Birth*

MonthDayYear
Age
New or Returning Student?*

Returning StudentNew Student
Add Student 2?

Add Student 2
Student 2 Info
Student Name*

First NameLast Name
Date of Birth*

MonthDayYear
Age*
New or Returning Student?*

Returning StudentNew Student
Add Student 3?

Add Student 3
Student 3 Info
Student Name*

First NameLast Name
Date of Birth*

MonthDayYear
Age*
New or Returning Student?*

Returning StudentNew Student
Payment required to secure a spot. Class sizes are limited. $125 payment to be made by Venmo @NsStrides . If this is an issue please reach out to me at 504-952-4691
Notes:
Terms and Conditions
Today's Date

MonthDayYear
Date
By checking 'I Agree' below and submitting this form, you, the Parent or Guardian of the above student(s), agree to release NORTHSHORE STRIDES, LLC, including instructors and assistants from liability for any and all injuries which may occur while training, practicing, performing, or during any related event or activity. You also agree that you are responsible for health and accident insurance and any medical costs incurred due to injury. You give permission for emergency medical transportation and treatment of your student(s) at your expense should the need arise.
Type a question*

I Agree
Should be Empty:

8-week Spring Fitness Session

Parent/Guardian Info

Student Info

Student 2 Info

Student 3 Info

Terms and Conditions