KGM Soccer Registration Form
Redstone Children's Academy
Parent Contact:
*
First Name
Last Name
Parent Email:
*
example@example.com
Parent Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Name:
*
First Name
Last Name
Child's Date of Birth:
*
-
Month
-
Day
Year
Date
Child's Age: (Must be 2 or Older)
*
Child's T-Shirt Size:
*
Child's Shoe Size:
*
I would like to be billed:
*
Monthly ($50/month, March-July) (Due the 15th of each month)
Semesterly ($200 One Time)
Parental Consent:
*
I authorize Redstone Children's Academy to bill my account for the $75 registration fee, tuition according to the plan selected above. Payments will be processed through ProCare.
I understand that movement activities involve inherent risks of injury, and I assume all risks associated with my child’s participation, including but not limited to, the risk of injury from falls, collisions, or other accidents. I hereby agree to indemnify and hold harmless Kids Gotta Move, its owners, employees, agents, and volunteers from any and all liability, claims, or demands arising out of or connected with my child’s participation in any dance class, activity, or event sponsored by or in connection with Kids Gotta Move.
I authorize the use of my child’s image or likeness in photographs, videos, or other media for promotional or educational purposes by Kids Gotta Move.
Parent Signature:
Submit
Should be Empty: