Registration
Details: Obstacle courses and other fun equipment for children to play & explore. You are welcome and encouraged to bring friends and/or family members! *Parents are responsible for supervising their own children. Price: $5.00 per child Pre-registration is not required but preferred.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Release of Liability
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Medical Emergencies
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Dress Code
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Sickness Policy
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Parking Lot Policy
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Care of Students
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Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*