Tinkergarten Fall 2024 Registration Form

Tinkergarten with Amy Fall - Focus

Fridays 10am - 11am
This is for our 6 week Spring Tinkergarten Program. Classes will be every Friday from 10am-11am from September 27th - November 1st

Children 18 months - 7 years are welcome.

Cost for the 6 weeks $150. Sibling discount: $75 for each additional child.

Payment can be made via Venmo or Zelle. Cash and checks are also accepted but will need to be brought at the start of the first session.

Venmo: AmyTrotta

We will meet at Lighthouse Park Fridays. We will meet near the side parking lot off of Stern Ave (NOT the main side that faces Lighthouse Dr.) This side is close to the basketball courts and will keep us away from pickle ball traffic.
Member ID
Tinkergarten Explorer's Information
Explorer's Name
Nickname
Date of Birth

MonthDayYear
Age
Full 6 week session or 3 week package (Discount applied if you register before Sept 20th!)

Other
May I include photos/videos of you and your child(ren) on social media? Please note: I take photos sparingly and will never include names of children or specific details. I share photos of play to celebrate the joy of our learning together and to support marketing/growing our class community.
Is there anything you would like to share to help me better support you and your child? (Allergies, interests, etc)

Parents' Information

Parent/Guardian 1
Parent/Guardian 1

First NameLast Name
Relationship to Child
E-mail
example@example.com
Cell Phone
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 2 (optional)
E-mail
example@example.com
Cell Phone
Format: (000) 000-0000.
Payment and Statement of Understanding
Release Form
The teacher, Amy Trotta, is deeply committed to every child’s safety and carefully assesses and manages danger in all of our activities. However, there are risks inherent in any children/youth activity. Each family must submit this completed form in order to participate.

Acknowledgement of Risk and Consent for Treatment: I acknowledge that there are risks inherent in any youth program, including by not limited to injury arising from: participation in physical activity; participant’s failure to follow instructions given by the teacher; communicable illness; and independent acts of third parties not under the control of the teacher. I acknowledge that all risks cannot be prevented, and assume those beyond the control of the teacher. In order to minimize risks to my child or other participants, I will take responsibility to see that my child is prepared for all activities and is in good health each day of class. In case of medical emergency, I understand that every reasonable attempt will be made to contact me. However, in the event that I cannot be reached, I give my permission to the teacher in charge of the class to secure emergency medical treatment for my child. I agree to pay for any charges for emergency medical treatment that are not covered by my personal health insurance.

PAYMENT:

After registration form is complete i will send an e-mail regarding payment options.
Sign Document
Date Signed

MonthDayYear
Should be Empty:

Tinkergarten with Amy Fall - Focus

Tinkergarten Explorer's Information

Parents' Information

Payment and Statement of Understanding