Registration
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Preschool Stay & Play (Open Gym) Time: 9:30am - 11:30am Ages: 12 months-5 years old Registration: $15 for one child & $25 for families Required: Parents must stay & Children 3 years old and younger must be accompanied by a parent on the gym floor Optional: We encourage all to bring water & a snack Schedule: Every 3rd Thursday of the month
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
Home Phone:
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Cell #:
Work #:
Email:
(Emails are kept confidential)
Address:
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City:
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State:
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AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
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WV
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Zip:
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Emergency Contact Info
*
Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
*
Photo release (Y/N):
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
*
Photo release (Y/N):
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
*
Photo release (Y/N):
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
*
Photo release (Y/N):
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
*
Photo release (Y/N):
*
Questions/Options:
Any allergies or additional information we should know of?
There will be no refunds for any reason. By enrolling in this Preschool Camp, you are confirming that you have read and understand our no refunds policy.
*
Yes
No
Additional Information:
Release of Liability
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You (the guest) are aware that you are engaging in physical exercise and that the use of exercise equipment, club facility training, and instructions, could cause injury to you. You are voluntarily participating in these activities and assume all risks of injury that might result. You agree to waive any claims or rights you might otherwise have to sue the facilities owner, office staff, and employees. You agree to waive and recommend whether you are sufficiently physically fit for any exercise activities. It is always advisable to consult your physician before undertaking a physical exercise program.
I've read the above and agree.
No Refunds
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There will be no refunds for any reason. By enrolling in this Preschool Camp, you are confirming that you have read and understand our no refunds policy.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Name as it appears on card:
*
Nickname:
Card Expiration Month:
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Exp Year:
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2025
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Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
*
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