Registration
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EVOLVEkids Parents Night Out takes place once a month on a Saturday from 6PM thru 10PM, where your kids can take advantage of a gymnastics, tumbling, and cheer Open Gym plus a movie on our inflatable Jumbo screen with some snacks as well.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
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
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Emergency Contact Info (Not Contact #1 or #2)
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
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:
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
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:
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
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:
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
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:
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
Additional Information:
Parents' Night Out Rules
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Only school -age children may participate in EVOLVEkids Parents' Night Out. Parents' Night Out starts at 6PM and ends promptly at 10PM. Parents must sign their child in and must enter the building to sign their child out. It is required that you are present to sign your child out at 10PM. Parents are expected to be available at the contact number that you provide in the unlikely event of an emergency. Parents' Night Out is $20 for one child or $30 for all your children, and we will charge your credit card on file as soon as we have processed your registration. If you do not have a credit card on file, please provide one in the registration form. Your child/children's spot is not confirmed until we have successfully charged your credit card. Parent's Night Out is professionally supervised but it is not a curriculum based class.
I've read the above and agree.
Waiver And Release of Liability
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I hereby certify that my child (children) has permission to participate in the recreational activities of gymnastics, tumbling, cheer, and other Parents' Night Out related activities at EVOLVEkids. I understand there is risk of severe injury while participating in these activities and I hereby release and hold harmless EVOLVEkids Inc., and any EVOLVEkids Inc. staff member, employee, volunteer, and/or agent for any injury my child may sustain as a result of his/her participation in gymnastics, tumbling, and other Parents' Night Out related activities at EVOLVEkids. I hereby agree that I am responsible for any and/or all hospitalization, medical emergency, or other medical treatment costs as a result of such injury by providing him/her with proper medical coverage, or I personally assume responsibility for such costs. In case of emergency, I hereby grant EVOLVEkids Inc., or any staff member, employee, or agent of EVOLVEkids Inc., the right to request medical attention for my child including calling medical professionals. I understand that EVOLVEkids Inc. and its staff will not assume guardianship of a child that is dropped off at the facility without a guardian and therefore it is my responsibility to care for and/or contact the child's guardian in the event that the child becomes ill or injured. I understand that EVOLVEkids Inc. reserves the right to cancel or reschedule all Parents' Night Out events for legitimate purposes.
I've read the above and agree.
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