Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender *

Female

Male

Select Your Program *

GROUP CLASS - Adult gymnastics group class for beginners on Sunday from 9:00 a.m. to 9:40 a.m. (40 min. a week) = $95/month

Pick a Start Date *

Please indicate the day of your first class. First month's tuition is due upon submitting your registration. If tuition is not paid within one week, the space will not be reserved.

MM

DD

YYYY

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name *

First Name

Last Name

Emergency Contact's Phone Number *

(###)

###

####

MEMBERSHIP AGREEMENT: In consideration of my membership in Manakoa Gymnastics and my participation in Manakoa Gymnastics’ classes, events, competitions, and activities, I agree to be bound by each of the following: 1. ELIGIBILITY: I agree to comply with the rules of Manakoa Gymnastics. 2. MISSED CLASSES: There are no make-ups for missed classes. Any missed classes are forfeited. 3. HOLIDAYS/GYM CLOSURES: Holidays (gym closures) are not included in the price of tuition, which means when you pay for tuition you are not paying for gym closures. The instructional calendar does not include closures because the instructional minutes to cover for potential loss of days were included in the calendar, and therefore, excluded from the price of tuition. Please refer to our website for a current list of holiday and gym closures. 4. TUITION: Tuition is payable in advance and non-refundable. 5. DIS-ENROLLMENT: To disenroll and cancel automated payments under your agreement, you must email us with at least 7 days advanced notice prior to the end of your monthly billing cycle at manakoagym@gmail.com. ONCE TUITION IS PROCESSED IT IS NON-REFUNDABLE. 7. PHOTO RELEASE: I further agree that Participants involved in Manakoa Gymnastics’ programs may be photographed and such photographs may be used to publicize Manakoa Gymnastics’ programs/activities. 8. AUTOMATED PAYMENTS: I authorize Manakoa Gymnastics to automatically charge my credit card or ATM on file for my future payments. To disenroll and cancel automated payments under this agreement, email us with at least 3 days advanced notice prior to the end of your monthly billing cycle at manakoagym@gmail.com. 9. LATE PAYMENTS: Late payment of tuition due to a declined card will incur a $20 late fee. Payment must be made within ten days of your billing date, otherwise membership will be deactivated and any balance left unpaid will be reported to the credit card company. 10. WAIVER & RELEASE: I am aware that gymnastics is a dangerous activity that could result in injury, paralysis, or even death. I assume all risks of injury or loss to myself arising from the Manakoa Gymnastics' classes/programs/activities. In exchange for me being allowed to participate in Manakoa Gymnastics’ classes/programs/activities, I release, discharge and agree to indemnify and hold harmless Manakoa Gymnastics, its employees, officers, or agents (the “Released Parties”) from any liability, loss or damage, including but not limited to that arising from the negligence of any of the Released Parties, which may result to me. I hereby verify by my digital signature below that I fully understand and accept each of the above conditions for permitting me to participate in classes, events, competitions, and activities conducted at Manakoa Gymnastics. *

Please type your name below. This will be considered your digital signature.

First Name

Last Name