Theraplay Group are excited to welcome you and your child to our TheraPLAY classes, where we focus on nurturing the whole child through a balanced blend of structured learning and open play. Our program is designed for children ages 2-6 and runs from September 9, 2024 until the end of the fiscal year with a renewal period to be reviewed at that time. We ensure personalized attention and a supportive learning environment.

Program Highlights: 10:30 AM- 11:30 AM : Semi- Structured Learning - During this time, we engage your child in activities that build foundational skills essential for their developmental journey. Whether it's early literacy, motor skills, or social development, we tailor the activities to meet them where they are. 11:30 - 12:30: Open Play - Open play is an important part of your child's day, allowing them to explore, create, and interact with their peers in a more flexible and unstructured setting.

Our Philosophy: Developmental Baseline: We believe in meeting each child where they are developmentally, respecting their individual growth pace, and celebrating every milestone, big or small. Building the Foundation: Our curriculum is designed to lay the groundwork for your child's future learning. We focus on creating a strong foundation that will support their academic and social success in the years to come. Regulation Before Expectation: We understand that emotional regulation is key to successful learning. That's why we prioritize helping children learn to manage their emotions and behaviors before expecting them to tackle new challenges. Child First: Our approach is rooted in a deep understanding of the nervous system. We create a safe and nurturing environment where your child feels secure and ready to

Program Details: Class Times: Monday starting at 10:30 AM Duration: Starting September 9th 2024 with calendar breaks to be provided to you

Class Size: Limited to 30 children

Cost: $35 for the open house event

We look forward to partnering with you and your child in this exciting journey of growth and learning!

Chew Necklace for Mouthing Behaviors and Pacifiers are permitted. Cancellation Policy: If a student misses a day of class they will be charged for the full amount of that day. Because of the nature of our class, we only allow for a minimal number of clients to attend to ensure we are able to prompt appropriate skills and work with each child individually. Your payment holds your spot and once the spots are full, we have a wait list for those who wish to attend. Many families wish to bring their children to our class and if you do not plan on attending we would like to provide that spot to another family. Payments for days enrolled are non-refundable. Early Drop Off or Late Pick Up Fees: Class starts promptly at 10:30 AM and ends promptly at 12:30 PM. We cannot take children early as we are not staffed for early drop off. If you arrive earlier or later than your scheduled class time this will change our teacher to student ratio. We understand that life happens but ALL families are to arrive at least 5 minutes prior to your scheduled pick up time so the instructors are able to discuss your student's day. If you pick your child up more than 15 minutes late you will be charged our late pick up rate of

Name of Parent 1/Legal Guardian

Please enter a valid phone number.

Please enter a valid phone number.

Does your child have siblings?

TheraPlay Group is a full inclusion event for ALL kids of ALL abilities. This includes all behaviors. Our staff understand that all campers exhibit different behaviors for different reasons. With this being said, we want to ensure that ALL members are safe during their days at TheraPLAY Groups. If we observe campers exhibiting aggressive** behaviors, parents will be notified immediately. **Aggression is the act or attempted act of causing harm to another. This may or may not include hitting, kicking, biting, shoving, pinching, or pulling hair. Aggression may or may not leave a visible mark on another individual. It is up to staff what constitutes aggression.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC

SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

I have read, understand and agree with this behavior policy. Parent/Guardian (Signature)*

I have reviewed the program and activities of TheraPlay Group and feel the child can participate without any restrictions or adaptationsl have reviewed the program and activities of TheraPlay Group and feel the child can participate with the following restrictions or adaptations: What restrictions and/or adaptations are necessary for your child to participate if any?

In my place, I hereby designate WRTS's employees/gym staff, to be present in my stead during the child's visits to TheraPlay Group. This determination is voluntary and is my sole responsibility and I waive all claims and/or actions against TheraPlay Group for my decision. Unless revoked in writing, this authorization shall remain in effect during the child's use of the facilities at TheraPlay Group. By signing this form I acknowledge that I understand that TheraPlay Group is not an

TheraPlay Group Customer Release of Liability. Indemnity Agreement. and Assumption of Risk

TheraPlay Group Customer Release of Liability, Indemnity Agreement, and Assumption

In consideration of being permitted by TheraPlay Group (hereinafter "TPG") to participate in its activities and to use its equipment and facilities, now and in the future, I

parent or legal guardian of "Minor"), hereby grant the permission necessary to allow Minor to participate in all activities at any class TPG location and agree with all the terms of this Release of Liability, Indemnity Agreement, and Assumption of Risk Agreement (hereinafter "Agreement" I, in my own behalf and on behalf of Minor, further agree to release, indemnify and discharge TPG, its agents, owners, shareholders, directors, partners, employees, volunteers, manufacturers, participants,

lessors, affiliates, its subsidiaries, related and affiliated entities, successors and assigns (hereinafter "Released Parties"), on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and

1. I understand and acknowledge that the activity the Minor is about to voluntarily engage in as a participant bears certain known risks and unanticipated risks which could result in physical, emotional, or mental injury, paralysis, illness or disease, death, or damage to Minor, to property, or to third parties. I, the legal guardian listed below

risks simply cannot be eliminated without jeopardizing the essential qualities of the

The risks include, among other things: Use of TPG equipment entail certain risks that simply cannot be eliminated without jeopardizing the essential qualities of the activity. Use of equipment may expose participants to the usual risk of cuts, scrapes, bruises, and rug burns. Other more serious risks exist as well. Participants may fall off equipment, sprain, injure, or break fingers, toes, wrists, feet, legs, back, or neck,

serious bodily injuries as well. In any event, if Minor is injured and may require medical assistance, you as parent or legal guardian will assume full liability and responsibility for the expenses. Furthermore, TPG employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They may give incomplete warnings or instructions, and the equipment being used might become loose, out of adjustment, or malfunction. There

employees may be negligent in, among other things, monitoring and supervising use of its equipment and facilities and in the maintenance and repair of its equipment and facilities. 2. I agree that this Release of Liability, Indemnity Agreement, and Assumption of Risk Agreement is made on behalf of that Minor participant and that all of the releases, waivers and promises herein are binding on that Minor participant. I represent that I have full authority as Parent or Legal

the minor participant to bind the Minor participant to this Agreement. 3. I expressly agree and promise to accept and assume all of the risks existing in this activity on behalf of Minor. The Minor's participation in this activity is purely voluntary, and I elect to have Minor participate in spite of

4. I hereby voluntarily release, forever discharge, and agree to defend, indemnify and

TPG and all Released Parties from any and all claims, demands, or causes of action, which are in any way connected with Minor's participation in this activity or use of TPG equipment or facilities, including any such claims which allege negligent acts or omissions of Released Parties. 5. I indemnify and save and hold harmless TPG and the Released Parties against any loss, liability, damage or cost that may incur arising out of or in any way connected with the Minor's

equipment or gear provided therewith or any acts or omissions of the Released Parties. 6. Should TPG or anyone acting on its behalf, be required to incur attorney's fees and

agreement, I agree to indemnify and hold them harmless for all such fees and costs. This means that I will pay

all of those attorney's fees and costs myself.

7. I certify that I have adequate insurance to cover any injury or damage that Minor may

participating in all TPG activities, or else I agree to bear the costs of such injury or damage to Minor myself. I further certify that I am willing to assume the risk of any medical or physical condition that Minor may have. 8. I expressly agree that this Agreement is governed by the State of Ohio and is

intended to be as broad and inclusive as

permitted by Ohio law, and that in the event any portion of this Agreement is determined to be invalid, illegal, or unenforceable, the validity, legality and enforceability of the balance of the Agreement

impaired in any way and shall continue in full legal force and effect. In the event that I file a lawsuit against TPG, I agree to do so solely in the State of Ohio and I further agree that the substantive law of the State of Ohio shall apply in that action without regard to the conflict of the law rules of that state. 9. I further agree to defend, indemnify and hold harmless TPG from any and all claims or lawsuits for personal injury, property damage or otherwise which are brought by, or on behalf of the Minor, and which are in any way connected with such use or participation by the Minor, including injuries or damages caused by the negligence of Released Parties, except injuries or damages caused by the sole negligence or willful misconduct of the party seeking indemnity. 10. I certify that, to the best of my knowledge, the Minor does not have a health

condition that would make it inadvisable

for the Minor to participate in TPG activities.

11. I agree to grant TPG and all Related Parties, the irrevocable right and permission to photograph and/or record me or Minor in connection with TPG to use the photograph and/or recording for all purposes, including advertising and promotional purposes, in any manner in any and all media now or hereafter known, in perpetuity throughout the world, without restriction as to alteration. I waive any right to inspect or approve the use of the photograph and/or recording, and acknowledge and agree that the rights granted to this release are without compensation of any kind. All photographs and/or recordings are exclusive to TPG. 12. In consideration of not being required to sign a fresh copy of this Agreement before each visit, I further agree that this Agreement shall apply to all future visits of the Minor to this and all TPG locations. 13. By signing this Agreement, I acknowledge that I have had sufficient opportunity to read this entire Agreement, Iunderstand it completely, I understand that it affects my legal rights, and I agree to be bound by its terms. I also agree if anyone is hurt or property damaged during the Minor's participation in this activity, I may be found by a court of law to have waived my or the Minor participant's right to maintain a lawsuit against TPG and the Released Parties on the basis of any claim from which I have released them herein. 14. By signing this agreement, you are acknowledging the TheraPlay Group is not a licensed Day Care.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS

BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.