| Gym & Learn Play School Registration Form |
Child's Name: ____________________________________ Nickname: _________________
Date of Birth: _________________________ Sex: M / F
Parent's Name: _____________________________________________________________
Mailing Address: ____________________________________________________________
City, St. & Zip: _____________________________________________________________
Home phone: (___) _____-________ Work: (___) _____-_______ Cell:(___) ____-______
Allergies: __________________________________________________________________
Email address: _____________________________________________________________
Date of Birth: _________________________ Sex: M / F
Parent's Name: _____________________________________________________________
Mailing Address: ____________________________________________________________
City, St. & Zip: _____________________________________________________________
Home phone: (___) _____-________ Work: (___) _____-_______ Cell:(___) ____-______
Allergies: __________________________________________________________________
Email address: _____________________________________________________________
| Students do not need be toilet-trained. *** Annual Registration Fee is $35, Plus supply fee of $30 *** Gym & Learn maintains a 1:8 teacher to student ratio (max enrolled: 16) |
TUITION – I understand tuition is due the first class of the session. I know there will be a $25.00 charge
for all NSF checks.
MISSED CLASSES – There are no refunds, credits, or prorating of fees for missed days, holidays or
class withdrawal.
Requirements: A signed waiver form, registration form, current immunization record and a medical
emergency form.
for all NSF checks.
MISSED CLASSES – There are no refunds, credits, or prorating of fees for missed days, holidays or
class withdrawal.
Requirements: A signed waiver form, registration form, current immunization record and a medical
emergency form.
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Which days are you interested in?__________________________________________
| Circle One Location: Woodbridge or Fredericksburg |