Just Kids Day Form
Welcome! Please complete the form.
Child Name
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First Name
Last Name
Child Age
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Child Date of Birth
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Month
-
Day
Year
Date
Child's Gender
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Boy
Girl
Relation to Child?
*
Please list the child's allergies.
*
Please specify if your child has any medical illness.
*
Parent Name
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First Name
Last Name
Select Date
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/
Month
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Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Liability Agreement Explanation
This is a permission slip and liability waiver from Just Kids Academy International for our Saturday care program ("Just Kids Day").
By signing, you, as the parent or legal guardian, are agreeing to permission for Attendance: You are giving your child permission to attend the Just Kids Day program on Saturdays between 11:00 AM and 5:00 PM. You understand that the program may include outdoor activities. You understand that the activities may cause muscle pain for your child. You agree not to sue Just Kids Academy International for muscle pain resulting from participation in the program. You acknowledge that you will be charged $1.00 for every minute you are late picking up your child after 5:15 PM. There is a $10.00 late pick of fee at 5:00 PM. This agreement allows your child to participate in the Saturday care program and confirms you understand the potential risks (like sore muscles) and the consequences of being late to pick them up.
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I have read the above and agree.
Signature
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Submit
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