Registration

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Storytelling Session, Craft Time, and a Gymnastics Class. / 9:30AM-11:00AM / Kids ages 2-5 years old. (2 year olds must be accompanied by a parent.) / $20 Registration, $5 Sibling Discount. / First 5 Families to sign up will recieve a free copy of the book. / Children being dropped off must be potty trained. / Each month on the First Thursday of the month.

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*

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: *	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?*
Who will be picking up your child? (ID required)*
By answering yes, I am confirming that I will be providing my child with a water and snack.*
There will be no refunds for any reason. By enrolling in this event, you are confirming that you have read and understand our no refunds policy.*

Additional Information:

Release of Liability

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I've read the above and agree.

No Refunds

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I've read the above and agree.

Enter your Full Name: