Class Pack Registration

Class Pack Registration Form
Name of Parent/Guardian *
Name of Parent/Guardian
Address *
Address
Phone *
Phone
Child Name (1) *
Child Name (1)
Date of Birth *
Date of Birth
Child Name (2)
Child Name (2)
If you have an additional child, please fill out his or her information.
Date of Birth
Date of Birth
Select your 10 classes *
* Pass not valid for Immersion Programs, Infant Development Classes, Parent Support Groups or 2s/3s Play Group
If you are unable to attend a class, cancellation must be made no later than 24h in advance. Make-up classes are not permitted if advanced cancellation notice is not provided.
Class 1 Date *
Class 1 Date
Class 2 Date *
Class 2 Date
Class 3 Date *
Class 3 Date
Class 4 Date *
Class 4 Date
Class 5 Date *
Class 5 Date
Class 6 Date *
Class 6 Date
Class 7 Date *
Class 7 Date
Class 8 Date *
Class 8 Date
Class 9 Date *
Class 9 Date
Class 10 Date *
Class 10 Date
Emergency Contact Name *
Emergency Contact Name
Phone Number *
Phone Number
If none, please write N/A
Playspace Policies & Liability
Playspace Policies *
1. Under no circumstance can a child be left at Tot Town under the supervision of Tot Town personnel without prior mutual agreement. 2. No strollers or shoes indoors. 3. Enter Outdoor Play Space without shoes at your own risk. 4. No running indoors or rough play. 5. Climbing Wall must be used with adult supervision. 6. Infant Nook is for Infants 12-24 months ONLY / No walking or jumping on Nook bumpers or archway 7. No pets allowed. 8. No food, bags or coats in the rear space unless authorized by Tot Town staff. 9. Parent/caregiver must supervise children during outdoor play; Play Space Assistants support children and caregivers indoors only. Exception: During member only drop-offs. 10. Please reschedule your visit to Tot Town if you or your child is ill. 11. All Toys are the property of Tot Town; children are not permitted to take any toy home. Please check your child’s pockets and bags before leaving. 12. All balances due must be paid prior to receiving services unless otherwise specified. 13. All guests must sign in and out unless attending a special event. 14. Photo ID may be required.
Liability Waiver *
I assume full responsibility for myself and my Child at Tot Town I indemnify, defend and hold harmless, release, and discharge Tot Town LLC, and its successors, and assigns, agents, members, administrators, volunteers, employees and attorneys from and against all losses, labilities, claims, demands, actions, damages, fines, fees, costs (including attorney fees), judgements and executions that I or Child ever had, now have, or may in the future have against Tot Town, and its successors, and assigns, agents, members, administrators, volunteers, employees and attorneys. For the avoidance of any doubt, I release Tot Town from any and all personal injuries known or unknown, and damage to property caused by, or arising out of, my participation or my Child’s participation in any activities at or organized by Tot Town.