Registration
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Already a customer? Click the red link above to login to your Parent Portal to register. Already a customer? Click the red link above to login to your Parent Portal to register. We have the best toddler and preschool events around! Sign up below :) A Toddler Time Event happens once a session. Children 15 months to 5 years old participate with their parent and coaches searching for colorful eggs around the gym. Open gym is included in the event. Kids learn the basics such as colors, shapes, letters, and numbers. Children will receive a goody bag with a popsicle at the conclusion of the event. Non-members welcome $20; Members discount rate $15 (discount processed after registration by staff prior to cc processing). Parental Participation during the event is required.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Friend
Guardian
Mother
Nanny
Parent
Relative
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)
Disabilities and/or Special Needs (Leave blank if NONE):
Allergies and/or Medications (Leave blank if NONE):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities and/or Special Needs (Leave blank if NONE):
Allergies and/or Medications (Leave blank if NONE):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities and/or Special Needs (Leave blank if NONE):
Allergies and/or Medications (Leave blank if NONE):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities and/or Special Needs (Leave blank if NONE):
Allergies and/or Medications (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities and/or Special Needs (Leave blank if NONE):
Allergies and/or Medications (Leave blank if NONE):
Questions/Options:
I understand that all participants are required to have a liability waiver signed by their parent or legal guardian in order to participate.
*
Yes
No
I understand that C.I.T.Y. Club staff will manually adjust Non-Member/Member fee prior to credit card being charged.
*
Yes
No
I understand that parent or nanny participation is required, and only one adult per child is permitted in the building.
*
Yes
No
MAKE-UP OPTION: Please type in the date of the missed class and the fee will be manually removed. One make-up per session permitted.
Additional Information:
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Amex
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
*
01
02
03
04
05
06
07
08
09
10
11
12
Exp Year:
*
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
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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