Registration
4 openings left in this event!
You are invited to a birthday party at Head Over Heels! We are very excited to have you join us! In order for your child(ren) to participate in this event, a parent or guardian must fill out the following information! If you do have questions that pertain to our facility and programs, please reach out to us at Contact@headoverheelsvestal.com We are looking forward to seeing you soon!
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
 
 
Students entered below will be added to your family's account
 
Questions/Options:
What is the HOST birthday party child's name?*
Is the name correct above? We want to ensure you are registering for the correct birthday party event!*
Has your child or other siblings currently do, or have in the past, classes with us?*
 
Additional Information:
 
Acknowledgement of Photo/Video Release
  (Show-Hide Details)
I've read the above and agree.
 
Medical Emergencies - Permission to Treat
  (Show-Hide Details)
I've read the above and agree.
 
Notice of Risk / Release and Waiver of Liability
  (Show-Hide Details)
I've read the above and agree.
 
COVID-19 Addendum
  (Show-Hide Details)
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments: