Parent First Name *

Parent Last Name *

Phone *

Email *

Preferred Contact Method

Phone

Either

Street Address *

City *

State *

Country

Postal Code

How did you hear about us?

Friend/Referral

Social Media

Google

Other

If referred by someone please let us know who referred you:

Athlete Name

Athlete Date of Birth

Class of interest: (Our staff will reach out to confirm selection and answer questions)

What day of the week is your athlete available for class?

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

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Terms & Participant Waiver:

Terms:
At the end of your 4-week New Member Special, you will be transitioned to a full member and receive all member benefits. Regular monthly tuition will begin at that time. All 30 minute recreational classes are $65/month. All 45 minute recreational classes are $75/mo. The card you have provided on file here will be used for regular monthly billing unless updated or your membership is cancelled.

Waiver of Liability & Release Form:
I am aware of the nature of this activity and I hereby assume responsibility for the participant listed above to participate. I acknowledge that, while not common, any activity that involves height and motion (such as bounce houses, tumbling and stunting) involves risk of injury ranging from minor (bruises and sprains) to more serious and catastrophic injuries. I will not hold Topeka Elite Cheer or its employees responsible in the case of accident or injury as a result of this participation. I understand that this completed form must be in the possession of Topeka Elite Cheer prior to participation in any program. If, at any point, I have a question or a concern regarding the safety of my child or the intent of the program, I will contact the owner, manager or instructor immediately. I also allow the participants listed to be photographed and videotaped for publicity and advertising purposes only.

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$ 49