Explorers & Tiny Talkers Classes

Explorers & Tiny Talkers Classes
Child's Name

First NameLast Name
Class Selection
Classes will begin Thursday July 16th.

There will be 4 classes total with the last class of this series being on 8/6/2026

We are so excited your here and looking forward to welcoming you all!
Parent Information

First NameLast Name
Child's Gender
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address
Please list any allergies, if none, please type N/A.Type a question
Please list any disabilities or medical diagnoses below, if none, please type N/A
Please tell us about your child (interests, favorite activities, etc.).
Emergency Contact Name & Phone Number
Stay connected with Vibrant Therapy Services!

Do you authorize Vibrant Therapy Services LLC to photograph and/or video record your child for use on social media, our website, and marketing materials?
Equipment & Materials Use: I authorize my child to use therapeutic materials, sensory equipment, and tools available at Vibrant Therapy Services LLC facilities. I understand that sensory equipment including but not limited to swings, trampolines, balance equipment, and tactile materials will be used. I release Vibrant Therapy Services LLC from liability for any injuries resulting from the use of such equipment except in cases of gross negligence or failure to supervise. Do you authorize your child to use therapeutic materials, sensory equipment, and tools available at Vibrant Therapy Services LLC including swings, trampolines, balance equipment, and tactile materials?
Allergies & Sensory Materials: I confirm that I have disclosed all known allergies including but not limited to latex, food-based sensory materials, and tactile sensitivities in the health section of this form. I understand it is my responsibility to update Vibrant Therapy Services LLC of any changes to my child's allergies or sensitivities prior to participation.
Does your child have any known allergies or sensitivities to materials that may be used during activities including latex, food-based sensory materials (shaving cream, pudding, rice, beans), tactile materials (kinetic sand, putty, slime, playdough), or scented materials?
If yes, please list all known allergies and sensitivities:
Child Participation & Liability Waiver Vibrant Therapy Services
By signing below I voluntarily enroll my child in Vibrant Therapy Services LLC classes and agree to the following:

1. Voluntary Participation: I understand that participation in classes and activities at Vibrant Therapy Services LLC is voluntary and I authorize my child to fully participate in all class activities including the use of sensory equipment, therapeutic materials, and physical activities.

2. Liability Release: I release Vibrant Therapy Services LLC, its owners, staff, and volunteers from any claims, injuries, or damages arising from my child's participation except in cases of gross negligence.

3. Medical Authorization: In the event of an emergency and if I cannot be reached I authorize Vibrant Therapy Services LLC staff to seek immediate medical attention for my child. I confirm that all health information provided in this form is accurate and complete.

4. Health & Safety: I agree to keep my child home if they are ill and will notify Vibrant Therapy Services LLC of any changes to my child's health, medications, or needs prior to class.
Parent/Guardian Full Legal Name

First NameLast Name
Signature
Date

MonthDayYear
Date
PARENT/GUARDIAN PARTICIPATION & LIABILITY AGREEMENT Vibrant Therapy Services LLC
By signing below I agree to the following:

1. Safety & Liability: I assume responsibility for my own safety while on premises and release Vibrant Therapy Services LLC from liability for injuries sustained during participation except in cases of gross negligence. I will not use sensory equipment unless directed by staff.

2. Participation: I will follow staff direction at all times, support my child's participation without interfering, and silence my phone during class. Staff may ask me to step out if my presence affects my child's or the group's participation.

3. Conduct: I will treat all staff, children, and families with respect. Disrespectful or aggressive behavior will result in immediate dismissal without refund.

4. Recording & Social Media: I will not photograph, record, or post images of any other child on premises or on social media without written consent.

5. Confidentiality: I will keep all information about other children and families I observe at Vibrant Therapy Services LLC strictly confidential including diagnoses, behaviors, and therapy activities.

6. Policies: I agree to all program policies including punctuality, pickup, and cancellation terms.
We are so excited to have your child join us! Please note that all class fees are non-refundable. We are unable to offer refunds or credits for missed classes. We appreciate your understanding as this allows us to maintain small class sizes and dedicated resources for every enrolled child.
Parent/Guardian Full Legal Name

First NameLast Name
Signature
Date

MonthDayYear
Date
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Explorers & Tiny Talkers Classes

Child Participation & Liability Waiver Vibrant Therapy Services

PARENT/GUARDIAN PARTICIPATION & LIABILITY AGREEMENT Vibrant Therapy Services LLC

My Products