Event Registration Form
All events include themed hands-on activities & snack *Sibling & Referral Discount $10 off. Select Below to Register
Wicked Wednesday $40
Wednesday, May 13th 4-6PM
Ninja Turtle Tuesday $40
Tuesday, May 19th 4-6PM
KPOP Class $40
Wednesday, June 3rd 4-6PM
Student Name
*
First Name
Age/Grade
Last Name
Address
*
Street Address
City
State / Province
Postal / Zip Code
Parent E-mail
*
example@example.com
Parent Mobile Number
*
Format: (000) 000-0000.
Please list student allergies/medical conditions and an emergency contact if parent cannot be reached
*
PHOTO RELEASE: I hereby authorize SMART START LLC to publish photographs & videos taken of my child(ren)for use in print, online, social media and for any other company publications.I hereby release and hold harmless SMART START LLC from any reasonable expectation of privacy or confidentiality associated with any taken images specified above.I further acknowledge that my participation is voluntary and that I will not receive compensation of any type associated with the taking or publication of these photographs, videos or company publications. I hereby release SMART START LLC and its employees and other parties involved from liability for any claims by me or any other party connected to my participation.
*
YES
NO
Parent Signature
*
Date
*
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: