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Are you purchasing specific days or weekly packages?*
What camps would your child like to attend?*
Number Of Weeks You Are Registering For:*
Enter the specific Dates you plan to purchase below with Name of the camp beside it.*
Number Of Individual Days You Are Registering For*
Is your child currently enrolled in a class at Elite Gym?*
Member Form
Child's Name*
First Last
Child's Age*
Parent's Name*
First Last
Email*
Phone*
Any health problems?*
Please explain.
Any allergies?*
Please explain.
Non-Member Form
Child's Name*
First Last
Child's Age*
Birthdate*
Grade*
Email*
Phone*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Mother's Name*
First Last
Employer
Cell Phone Number
Work Phone Number
Father's Name*
First Last
Employer
Work Phone Number
Cell Phone Number
Emergency Contact 1*
First Last
Relationship*
Phone Number*
Emergency Contact 1*
First Last
Relationship*
Phone Number*
Any health problems?*
Please explain.
Any allergies?*
Please explain.
Release
I hereby authorize Elite School LLC to act for me according to their best judgement in any emergency requiring medical attention. The undersigned hereby acknowledges that participation in recreational programs involves inherent risk of physical injury, catastrophic injury, or even death. The undersigned assumes all such risks and agrees to waive and release Elite School LLC, its owners, employees, and affiliates from any liability for injuries or death incurred while involved in a program on or off the premises. The undersigned also assumes all medical costs incurred as a result of such an accident. This waiver is also applicable to any transportation in the Elite vans.

Please type the following. This will serve as your digital signature.
Your Name*
First Last
Guardian For*
First Last
Date*
Date Format: MM slash DD slash YYYY
Initial - I give permission to Elite Gym to use pictures of my child to post on the Elite Facebook page and Website.*
Notes
Payment
Payment due in full at the time of registration. NO REFUNDS. After submitting, please call the gym to make payment.
Total Amount Due:
Price: $89.00
Phone Number*
Notes/Comments

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