6-Week Session Registration Form

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Please fill out the form below to secure your/your child's spot in one of our 6-Week Sessions. You will receive billing information after you have registered. Non-refundable payment is due in full prior to the start of class.

Email *

Student's Name *

Date of Birth *

YYYY

Phone Number *

Select Class(es) For Enrollment *

Wednesdays 9:15-10:00 Creative Movement for Children and Caregivers 18 Months - 3 Years

Wednesdays 10:15 - 11:00 Creative Movement and Tumbling Ages 2.5-4 Years

Required

Please indicate any medical conditions

In case of emergency, please contact the following person/people. Include names and phone numbers. *

I give The Complex permission to seek medical attention in case of emergency. I will not hold the studio responsible for injury or virus or for any medical attention sought for said emergency. *

Yes

Please type your name here as your electronic signature agreeing to the contract above. *

Submit

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