About Us

Fall 2010 Registration Form

Student's Name:  
Student's DOB:  
Age by 12/1/2009:  
Billing Address:  
City:       State     Zip:
Phone Number/Numbers:  
E-mail(please!!):  
(For Gym Bugs' use only - will not be distributed or sold under any circumstances!)

Please choose a class:

Pricing:
45 min: $280/semester ~ $56/month
1 Hour: $300/semester ~ $60/month
1.5 hours - 2 hrs 15 min: $420/semester ~ $84/month
2.5 - 3 hours: $600/semester ~ $120/month
3 hrs 15 min - 4 hours: $675/semester ~ $135/month

Registration Fee: $15.00 per year

Pay the full semester and receive a $20 discount!

Please choose a payment method:


If you are choosing the monthly payment option, you must fill out the following information:

Bank Name:  
Branch Location:  
City/State/Zip  
Routing #:   Account #:  


Parent/Guardian Name:
Parent/Guardian Name to serve as signature:
Date: