REGISTRATION FORM
SALTO Gymnastics, Dance & Tiny Tot Fitness
 
Brookfield
 
Waukesha
 
Male
 
Female
 
Session 1
 
Session 2
 
Both
Student's Name___________________________

Birthdate___________ Age______

Phone_________________

Address_________________________________________

City______________________

Zip_____________

Emergency Contact________________________________

Emergency Phone____________________________

Email Address (optional)____________________________

Class Level_________________________________

Day_____________________ Time___________________
A $20.00 NON-REFUNDABLE DEPOSIT MUST ACCOMPANY THIS REGISTRATION FOR EACH CLASS THE GYMNAST IS REGISTERING FOR. BALANCE DUE BEFORE CLASS STARTS. My child (or I) has (have) no physical, mental or emotional problems that would interfere with participation in this program. I have fully read and understand the Registration and Payment Procedure and have signed the Release and Acknowledgement of Risk Form. ANNUAL REGISTRATION FEE-All students are required to pay a $20.00 Annual Registration Fee per gymnast, or $35.00 per family that must be paid once each year.  For example, if the annual registration fee is first paid in January, it need not be paid again until the following January, etc.  Please include this fee with your payment for all NEW STUDENTS and any CURRENT STUDENTS whose anniversary month has arrived.  This will occur in January, June and September depending on which semester you first register in.
 
Signature______________________
                    (Parent or Guardian)		 Date__________ Class Fee______________________

Annual Registration Fee____________

Total Due_______________________

Deposit________________________

Balance________________________
 
 
 

Print Parents Name ____________________________
Make Checks Payable To:
SALTO, INC.
1417 Poplar Dr. 21950 Doral Rd.
Waukesha, WI 53188 Waukesha, WI 53186
 

Master Card & Visa Accepted
 
****Please read and sign the participant agreement and return with this form****