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Please fill out the following form in order to participate in our activity.

Children

List all children you are bringing to the event.

Adults

List additional adults who are approved for pickup

Waiver

I understand that the classes, programs and facilities (including Jungle play structure, gymnasium, and gymnastics room) offered by Kids Club Fun & Fitness, Inc. involve group participation in active physical activities, in areas of uneven floors, obstacles and equipment.  I acknowledge that there are inherent risks of injury to participants in such activities and to those who may accompany them, which may range from normal bumps and strains to potentially serious injuries up to and including even paralysis or death.  I represent to Kids Club that I have determined, with medical assistance if appropriate, that I and/o any child accompanying me is physically and mentally able to participate safely in strenuous physical activities and that there are no contraindications for our participation in the specific programs in which I am now or in the future may engage enroll.  I voluntarily accept the risks associated with me and my child’s participation in such activities.  I agree that Kids Club Fun & Fitness, Inc., its shareholders, employees, agents, officers, directors and contractors shall not be liable for, and I release and covenant for myself and accompanying children not to bring any lawsuit in any form, for any injury, loss or damage occurring in whole or in part as a result of participation in Kids Club programs or entering or using the facilities unless such injury, loss or damage is the result of such person’s/entities’ intentional misconduct or reckless disregard of known safety rules and regulations while we are under their instruction, supervision or control or otherwise on the  premises.

I understand that safeguarding and control of any property we bring to Kids Club is our responsibility and acknowledge and agree that Kids Club shall have no responsibility for loss, theft or damage to any such property, including equipment, uniforms, clothing or other personal items.

Consent For Emergency Medical Care

In the event of an injury for which immediate medical evaluation or care appears to be necessary, I hereby consent to Kids Club Fun & Fitness, Inc., and its agents arrangement for emergency transport, evaluation and medical care of myself or accompanying child as my agent and at my expense until such time as I or another person I have designated on the enrollment form is available to assume responsibility for such arrangement.  I release Kids Club and its agents from responsibility for such care.

Covid-19

An inherent risk of exposure to COVID-19 exists in any public place where people are present. COVID-19 is an extremely contagious disease that can lead to severe illness and death. According to the Centers for Disease Control and Prevention, senior citizens, and Guests, with underlying medical conditions are especially vulnerable.  By visiting Kids Club Fun and Fitness, you voluntarily assume all risks related to exposure to COVID-19.

Drop off is between 6:30-7:00pm only.  Pick up is from 9:30-10:00pm.

There is a $5 per MINUTE late fee for pickups after 10:00pm.

Thanks for submitting!

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