Daytime Phone Number
Home Address:
Nanny/Caregiver's Name
(optional)
1st Child's Name
1st Child's Date of Birth
My child has the following allergies, medical, and/or developmental conditions:
(optional)
8 class series/1st child: June 20th - August 15th: Sign up for 8 dates & save
($280.00 extra)
(optional)
June 20th @ 11:30a
($37.00 extra)
(optional)
June 27th @ 11:30a
($37.00 extra)
(optional)
July 11th @ 11:30a
($37.00 extra)
(optional)
July 18th @ 11:30a
($37.00 extra)
(optional)
July 25th @ 11:30a
($37.00 extra)
(optional)
August 1st @ 11:30a
($37.00 extra)
(optional)
August 8th @ 11:30a
($37.00 extra)
(optional)
August 15th @ 11:30a
($37.00 extra)
(optional)
2nd Child's Name
(optional)
2nd Child's Date of Birth
(optional)
My child has the following allergies, medical, and/or developmental conditions:
(optional)
8 class series/2nd child: June 20th - Aug. 15th: Sign up for all 8 dates & save
($252.00 extra)
(optional)
June 20th @ 11:30a
($33.00 extra)
(optional)
June 27th @11:30a
($33.00 extra)
(optional)
July 11th @ 11:30a
($33.00 extra)
(optional)
July 18th @ 11:30a
($33.00 extra)
(optional)
July 25th @ 11:30a
($33.00 extra)
(optional)
August 1st @ 11:30a
($33.00 extra)
(optional)
August 8th @ 11:30a
($33.00 extra)
(optional)
August 15th @ 11:30a
($33.00 extra)
(optional)
I understand that a 3.5% credit card processing fee will be applied
Class Policies and Waiver
#1. MAKE-UPS: We will do our best to offer a make-up for 1 -2 missed classes.
#2. ENROLLMENT & REFUNDS: 100% refunds will ONLY be issued prior to the start date of the session. Please contact us if you need to partially enroll or pro-rate a session. Refunds will not be given once the series has begun.
#3. CANCELLATION POLICY: We reserve the right to cancel any classes due to low enrollment or staff changes.
#4. PHOTOGRAPHY: PLEASE respect the privacy of others and NOT video record the instructors or the class.
#5. CELL PHONE USAGE: Texting and talking on cell phones is prohibited during the class.
#6. LIABILITY WAIVER: I hereby release and agree to hold Creative Play for Kids, Eileen Levine, the instructors, and the BPC parks department harmless from and waive on behalf of myself, my child(ren), and my child’s caregiver any and all illness, accidents or injury that may occur to me, my child, or my child’s caregiver; I agree to accept full responsibility for myself, my child’s caregiver, and my child while attending Creative Play for kids classes.
I voluntarily seek the services of Creative Play for Kids for my child and confirm that myself, my child, and/or caregiver is not experiencing any symptoms of illness such as coughing, shortness of breath, chills or fever that may be related to Covid-19. As such, I do believe to the best of my ability that neither myself, my child or my caregiver has been exposed to Covid-19 or anyone suspected to have the virus. This Liability Wavier and release extends to Creative Play for kids together with all owners and employees.
ACCEPT WAIVER:
I have read the class policies and waiver and agree to accept them. All the information on this registration form is accurate.
I agree and accept the conditions of the above waiver.
This Enrollment is for Movers on Mondays @ 11:30a.