School- Agers Classes & Open Play at K Peas Place Registration Form

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Parent's Name* This field is required.
First Name
Middle Name
Last Name
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Additional Caregivers bringing your children* This field is required.
First Name
Middle Name
Last Name
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Child's Name * This field is required.
First Name
Last Name
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Child's Age* This field is required.
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Child's Date of Birth* This field is required.
Date
Year
Month
Day
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Sibling- Child's Name
First Name
Last Name
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Sibling- Child's Date of Birth
Date
Year
Month
Day
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Sibling- Child's Name
First Name
Last Name
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Sibling- Child's Date of Birth
Date
Year
Month
Day
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Sibling- Child's Name
First Name
Last Name
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Sibling- Child's Date of Birth
Date
Year
Month
Day
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Afghanistan
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Poland
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Romania
Russia
Rwanda
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eSwatini
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E-mail* This field is required.
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Cell Phone* This field is required.
Area Code
Phone Number
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Check all that you've attended:* This field is required.Have we met before?
Music Class
Alphabet Baby/Toddler Learn & Play Class
Music Froggy Fitness Class
Alphabet Preschoolers Learn & Play Class
Open Play only- no class yet!
Lego Camp
SCHOOL-agers class & play 4-7yrs.
Birthday Party
Special Event
First time here
interested in Summer Camp including Art, Play & Music Class
Interested in attending special ART events
Other
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Class Details * This field is required.Welcome! Music Class = Music with Mar. Classes (ages 0-6yrs) an interactive educational music and movement program helping families/ caregivers bond, learn and grow together based on the latest brain research; Brain research proves that by introducing concepts through the use of music and movement and involving more senses, the information will more likely be retained. Music with Mar.'s Froggy Fitness Fun (0-7yr) an interactive high energy family class that promotes exercise, nutrition, and relaxation through music and movement. A great workout for everyone. Alphabet Learn & Play Class (babies/toddlers 0-2.5 & preschoolers 2.5-6yr) a semi-structured that includes table sensory activities, playtime, and circle time. School- Agers 4-7years. structured interactive class for children and their grown-ups. Focusing on listening skills, following directions, promoting confidence through FUN movement activities that are PLAYFUL! We're excited to continue our programs and offer you an opportunity to continue joy with your sweet peas in a time of crisis! "It's more than just singing & playing!" Dress comfortably and dedicate time with your children/ family! For over 20 years, I have had the joy to witness love in a special way and am excited to continue to connect, play and celebrate with each family I continue to meet! Love, Miss Karen "KP" Thank you! IN THE BOX BELOW- MENTION WHY you'd like to attend our classes! Please mention a time and day that would be ideal for your family. Mention who referred you to class.
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Add to TEXT reminders* This field is required.
YESNO
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Add to EMAIL reminders* This field is required.
YESNO
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Signature* This field is required.$25 open play only. $25 music class only. $80/ 5 music classes only, no open play. or $35 pay as I go one time class and same day play, 5 classes w/playtime $125 use in 2 months; 10 classes w/playtime $200 use in 3 months NOTE: by selecting a payment of $30 confirms your spot. You may upgrade to a package within one week from the date attended applying the $35 payment towards the package/ or unlimited. ($125 for 5 class used in two months, may be upgraded to a monthly unlimited- contract if you find you used the 5 classes within one month) ($350= 3 months unlimited paid upfront no Credit card on file.) Payments are non refundable. non transferrable. Thank you for taking time to fill out the form carefully * After SUMBITTING PAYMENT look for a CONFIRMATION number at the bottom of the form to confirm payment, if there is no confirmation number the payment has not been processed. This form works best from Desktop. If your payment is not processing just submit. You may pay cash, Venmo, or PayPal the day of. Double check your records! * Welcome~ In light of the continuing stress of covid -19, now the variant.... it’s crucial we have a clear understanding of our unique payment options! Our mission is not only to truly connect and celebrate each family but to provide FLEXIBILITY-AFFORDABILITY and a VARIETY of options for you to enjoy in a gracious time period as we know, no two days are the same with little ones! For this we do not require monthly auto enrollment, instead we offer prepaid discount return packages that are honored any day and time (not locked into days or times use it or lose it philosophy) and offer pay as you go, our unlimited is paid upfront, no credit cards on file. We will continue to enforce our policies as is, they have not changed... however, we’ve always been lenient with extensions and so forth! Important: Policies/ When you make a payment online you must join us within 2 weeks of the initial payment, NOT a month(s) later. We will begin the policy expiration for packages and monthly unlimited upon the first visit. This is extremely important for us for 2 reasons: #1 ~ we base our schedule on the quantity of commitments to ensure our mission is met, flexibility, affordability, variety! #2 ~ joining us regularly helps everyone, your child (ren), adults and me, your teacher! Relationships are part of what makes us so special. Thank you for being you, sharing your goals for your families! Each registration has value to our why! You found us, and we are so very thankful! We simply grow, tweak, groom, polish, the more we are together! With that said there is a happy medium... a balance and not over scheduling! Logistics/ more policies: In the event, that you must quarantine we will extend packages 2 extra weeks! In the event that K Peas Place must close to quarantine, we will extend packages 2 weeks! If you are monthly unlimited, we will extend one extra month from the last day attended. If you prepaid one visit and do not come, your visit may be used with in two weeks of purchase. More LOVE Thank you so much for understanding and supporting our family business and your fellow K Peas Families/ your friends! We all look forward to seeing each other! As we focus on fun while we are together, we will reserve the right to schedule discussions privately. Thank you! As always, I will cry with you and always have a conversation with you, feel free to call or email anytime. One last policy! What is new? Tuesdays open play 9:30-11:30 must RSVP Pops up classes must RSVP This is the ensure enough Participation. Weekly classes are established and do not require RSVP if you have a package or unlimited- we are expecting you!!!!!! Policies are understood. Oh and more LOVE our rates remain the same- per family!!!!! Not per child;) Understanding and Release of Liability in Regard to COVID-19 COVID-19 has been declared a worldwide pandemic by the World Health Organization. In order to resume regular business operations, K Peas Place has reduced capacity and standards of behavior to reduce the spread of COVID-19 while attending classes, open play and special events. Even with implementation of safety protocols, K Peas Place cannot guarantee that you or your child(ren) will not become infected with COVID-19; participation could increase your risk and/or your child(ren)'s risk of contracting COVID-19. ASSUMPTION OF RISK: K Peas Place cannot prevent you or your child/children from becoming exposed to, contracting, or spreading COVID-19 while attending classes, open play and special event activities. It is not possible to prevent against the presence of the disease. Therefore, if you choose for your child/children to K Peas Place, your child/children and/or other family members may be exposed to and/or at increased risk of contracting or spreading COVID-19. I/we have read and understood the above warning concerning COVID-19. I/we hereby choose to accept the risk of contracting COVID-19 for myself/ourselves, my/our child/children, and/or other family members in order for my/our child/children, to attend K Peas Place and related activities. By signing this agreement, I/we acknowledge the contagious nature of COVID-19 and that my/our child(ren) and I/we may be exposed to or infected by COVID-19 by attending and/or being present at K Peas Place, and/or by participating in class activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against the K Peas Place and each of their respective owners, officers, directors, managers, officials, trustees, agents, employees, authorized volunteers, or other representatives in connection with exposure, infection, and/or spread of COVID-19. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen. CHOICE OF LAW: I understand and agree that the law of the State of Florida will apply to this contract. I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE. I am the parent or legal guardian of the minor(s) named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release. I agree to the TERMS & CONDITIONS: We are excited to have you join us with your sweet peas for OPEN PLAY. We strive to provide a safe, clean, relaxing and educational experience for you to enjoy with your friends, family, and new found friends you meet here at K Peas Place. Prior to arrival ask yourself: To prevent the spread of COVID-19 and reduce the potential risk of exposure to our staff & friends, we ask that you help us take precautionary measures by honestly asking yourself the following questions and if the answer is "yes" to any of these questions, we ask that you refrain from coming to the K Peas Place until you are able to self-quarantine for 14 days. 1. Has anyone in your household returned from any of the countries listed on the CDC's Coronavirus FAQs within the last 14 days? 2. Has anyone in your household had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days? 3. Has anyone in your household been in close contact with anyone who has traveled outside of the country within the last 14 days? 4. Has anyone in your household experienced any cold or flu-like symptoms within the last 14 days (to include, fever, cough, sore throat, respiratory illness, difficulty breathing)? Arrival: · Remove shoes –wear socks (grippie socks are recommended) · Leave belongings in the front storage cabinet, bring minimal necessary items (lighten your load) · Sign in at front desk. · Hand sanitize (wash your hands in the bathroom before playing- sing Happy Birthday😊 as often as you need to) Playtime: · Enter play room- follow your child's lead. Prior to Covid we always sanitized and "STAGED” the playroom, rotating toys regularly. We continue to follow protocol. Reminder, if anything goes in their mouths place the items into the to be washed bin as usual for proper sanitization. · Children are never to be left unattended by the person that brought them to K Peas Place. · Communication is an important need for all whom choose to spend time here. If you do not speak English well or understand something please, bring a translator with you. We encourage you to talk with us open mindedly with compassion as we navigate early childhood with you. There are guidelines in place for classes to run smoothly and safely. Connect with us anytime, with any questions. . Keep food and beverages in the eating area. You may bring a water bottles/ drinks w/ closed lids. · Payments are non refundable and non transferrable. Welcome Back! REOPENING includes your love and support! We are grateful to be open to serve our amazing community! 1. Help us by sharing your positive praise on our google page and send your friends! 2. Book private birthday parties. 3. Join us for our enrichment classes to enjoy and be inspired! 4. We are excited! With much gratitude, Miss Karen and team “KP” Thank you for your support and understanding during these trying times! By choosing to come to K Peas Place indicates you are comfortable to be out and about. We understand young children learn through their senses and affection. Social distancing is not understood by children. As adults we can model & talk gently to guide them. Please, let go of your stressors here. Your time here at K Peas Place will continue to be a place of positivity! We understand the need to talk and discuss worldly events, however we like to think of K Peas Place as place to let it all go an just “BE” with your children. Connect. Play. Celebrate TODAY! You and your children deserve the laughter of early childhood! Though small in the size the ladybug is fearless. As fear cannot exist amongst, JOY, the ladybug brings a message of promise for they get us back in touch with the JOY of living~ we must let go of our fears and get back to our roots, to love!
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