Mama & Me Program Registration

Parent/Guardian Information

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Choose Your Class Option
We offer flexible class choices to fit your schedule and comfort.

☑ Check the box next to the class option that works best for your family.
Once selected, our team will follow up with all the details you need!

Informed Consent and Acknowledgement

I hereby give my approval for my child’s/childrens participation in any and all activities prepared by Playpourri International during this event. In exchange for the acceptance of said child’s/childrens candidacy by Playpourri International, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Playpourri International and all its respective officers, agents, and representatives from any and all liability for injuries to said child/children arising out of traveling to, participating in, or returning from this event.

In case of injury to said child, I hereby waive all claims against Playpourri International including all staff, coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all school activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

As Parent and/or Guardian of the named child/children, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination etc for the named child/children. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Playpourri International and its affiliates including Directors, Coaches, and Team Members to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the child's/childrens enrollment.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child/children, in my absence.

Photo and Video Release Authorization

As Parent and/or Guardian of the named child/children, I hereby authorize Playpourri International and its affiliates, including Directors, Coaches, Teachers, and Team Members, to photograph, record, and/or videotape my child during school activities, events, and programs. I understand that these images and recordings may be used for the purpose of sharing moments with families, promoting school activities on social media, and general marketing purposes.

Permission is hereby granted for Playpourri International to use my child’s likeness in photographs, videos, or other digital media in any and all of its publications, including but not limited to social media, newsletters, promotional materials, website content, and marketing campaigns, without further notification or compensation.

I understand that these images may be shared publicly through various media channels, and I waive any right to inspect or approve the finished product in which my child’s likeness appears. I further acknowledge that Playpourri International owns all rights to the media and that these images and recordings may be used at the organization’s discretion for educational, informational, and promotional purposes.

This authorization is granted permanently and remains in effect without expiration.

This release is executed of my own free will, with the sole purpose of allowing Playpourri International to document and share the enriching experiences provided to my child in a positive and professional manner.

If you do not wish for your child’s/childrens images to be used, please submit a written request to the school office. Your preferences will be honored to the best of our ability within the operational scope of our programs. I understand that opting out may limit my child’s inclusion in Kids Diary daily images.

Cancellation Policy

All cancellations are non-refundable and non-transferable. Once a booking has been confirmed, no refunds will be issued, and the payment cannot be applied to future services, events, or programs. By completing the registration, you acknowledge and agree to this policy.

Disclaimer

The English version of this form is the official text. Translations are provided for convenience and may contain errors. In case of discrepancies, the English version shall prevail.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.