Membership Form

Please complete and submit this form prior to your child's first class or activity. A child is not permitted to participate without our receipt of this form. Enrollment and payments can not be made online and must be completed by calling the office at 678-546-6626 or coming to the gym in person.

Reason for submitting form:*

If you are submitting this form as a Buddy for BRING A BUDDY WEEK, please list the name of our Gymnastix student you will be joining in the "Comments" section below.

Name of Student:*
Date of Birth:*
 / 
 / 
School Attending:*
Mother's Name:*
Father's Name:*
Address:*
Mother's E-mail:*
Father's E-mail:*
Home Phone:
-
Mother's Cell Phone:*
-
Father's Cell Phone:*
-
Comments:
Last 4 digits of SS# of Adult / Parent / Legal Guardian signing waiver *
Waiver & Release (please see the front desk for a copy of the Waiver & Release)*
Exempt Organization*
Rules & Policies (Please see the front desk for a copy of Rules & Policies)*
Electronic Signature*

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.