Baby Sing and Sign Registration

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Fall 2022

I would like to enroll in the following class: *

Tuesdays: September 6th - 27th, 10:15-11:00 (this session consists of 4 classes (once per week) and by signing up you are committing to attend the full session)

Tuesdays: October 4th - 25th, 10:15-11:00 (this session consists of 4 classes (once per week) and by signing up you are committing to attend the full session)

Tuesdays: November 1st-15th and the 29th (this session will not meet the week of Thanksgiving and by signing up you are committing to attend all 4 classes)

Required

Child's Name *

Child's DOB *

Caregiver's Name(s): *

Phone Number *

Can this phone number receive text messages? *

Yes

Required

Email *

Emergency Contact *

Person attending class with your child *

Relationship of person attending class with your child *

Mother

Father

Grandparent

Childcare provider

Other:

Required

Are you enrolled in Lawrence Parents As Teachers?

Yes

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How did you find out about Baby Sing and Sign? *

Permission to use photographs, videos, or other recordings *

Photographs, videos, or other recordings taken of my child(ren) and/or family members while in attendance at this class may be published in newspapers, magazines, television, publicity releases, and/or other media at the discretion of the teacher.

I agree

I disagree

Required

Waiver of liability *

With this enrollment, I release any and all rights and claims for damages against the instructor or USD497 in the unlikely event of injury sustained by myself, my child(ren), or assigned caregivers during the course or as a result of the musical activities in such classes. I understand that it is my duty to inform any caregiver assigned to bring my child to class of such waiver.

I agree

I disagree

Required

Class Location: Kennedy Early Childhood Center

1605 Davis Road (please enter through the main doors by the flagpole)

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