Read & Build with Duplo
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a member of The Clubhouse?
*
Please Select
Yes
No
How many of your children would you like to register?
*
Please Select
1
2
3
4
5
Child 1
*
First Name
Last Name
Child 1 Current Age
*
Child 2
*
First Name
Last Name
Child 2 Current Age
*
Child 3
*
First Name
Last Name
Child 3 Current Age
*
Child 4
*
First Name
Last Name
Child 4 Current Age
*
Child 5
*
First Name
Last Name
Child 5 Current Age
*
Are you planning to attend the mom's fitness class which occurs simultaneously to this Read & Build with Duplo class?
*
Please Select
No
Yes
I would like more information about this
Which classes are you registering your child(ren) for?
*
Please Select
Read & Build with Duplo - The Full Series
Read & Build with Duplo - One Class Only
On what class date will your child(ren) be attending?
*
-
Month
-
Day
Year
Date
Please choose either the series or the one day only option. Be sure to include all your children that you have listed on this registration in the quantity boxes below.
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Read & Build with Duplo - THE FULL SERIES
Registration for this series is non-refundable and non-transferable.
$
49.00
Quantity
1
2
3
4
5
Read & Build with Duplo - ONE DAY ONLY
Registration for this class is non-refundable and non-transferable.
$
10.00
Quantity
1
2
3
4
5
Credit Card
The Clubhouse may photograph images of me and/or my family, in whole or in part, at this event/class and publish them for promotional purposes online or in print.
*
I understand and agree
I take full responsibility (financially and otherwise) for the medical needs that may arise as a result of my family's participation at The Clubhouse in Holly Hill, including but not limited to allergies, minor first aid issues, accidents, communicable diseases etc. I understand that this event/class will be at a facility with a pool and agree to read and follow all posted signage for my safety.
*
I understand and agree
I accept that The Clubhouse is not responsible for any losses and/or damage to my vehicle or personal property during these classes.
*
I understand and agree
I understand I am responsible to read and abide by The Clubhouse's Code of Conduct. I recognize I am also responsible to ensure those I register do the same. I can review these in advance here: https://www.theclubhousehollyhill.com/frequently-asked
*
I understand and agree
I understand this is a "parent-inclusive" event/class and that I can choose to participate or observe the activity but must remain present and available for the duration. I must be responsible and accountable for all the minors attending with me. I will ensure the minors in my care understand aggressive or crass behavior towards others (both verbal and physical) and breaches to the code of conduct may result in our removal from the event.
*
I understand and agree
I understand this is a "parent-inclusive" event/class and that, even though I am attending the fitness class for moms, I must be available as needed for the duration of this class and I may not leave the property. I must be responsible and accountable for all the minors attending with me. I will ensure the minors in my care understand aggressive or crass behavior towards others (both verbal and physical) and breaches to the code of conduct may result in our removal from the event. I understand that I may attend the fitness class as long as my child is settled and capable of engaging on their own.
*
I understand and agree
I understand that if I decide to become a member of The Clubhouse, discounts on classes and events cannot be granted retroactively.
*
I understand and agree
I understand this registration is non-refundable and non-transferrable. I understand that if any class is cancelled (generally for unforeseeable circumstances outside the control of the facilitator), a make-up date will be offered at a comparable day/time.
*
I understand and agree
Is there anything you feel is important to communicate to the facilitator of this class? Do you have any specific questions relating to this class?
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