| Gym & Learn Play School Registration Form |
| 3310 Noble Pond Way #101, Woodbridge, VA 22193 703-878-0100 - kidsnmotionpp@comcast.net |
Child's Name: ____________________________________ Nickname: _________________
Date of Birth: _________________________ Sex: M / F
Parent's Name: _____________________________________________________________
Mailing Address: ____________________________________________________________
City, St. & Zip: _____________________________________________________________
Home phone: (___) _____-________ Work: (___) _____-_______ Cell:(___) ____-______
Allergies: __________________________________________________________________
Email address: _____________________________________________________________
Date of Birth: _________________________ Sex: M / F
Parent's Name: _____________________________________________________________
Mailing Address: ____________________________________________________________
City, St. & Zip: _____________________________________________________________
Home phone: (___) _____-________ Work: (___) _____-_______ Cell:(___) ____-______
Allergies: __________________________________________________________________
Email address: _____________________________________________________________
| All Students must be toilet-trained. *** Annual Registration Fee is $35, Includes Supply Fee *** Gym & Learn maintains a 1:8 teacher to student ratio (max enrolled: 16) |
TUITION – I understand tuition is due the first class of the session. I know there will be a $25.00 charge
for all NSF checks.
MISSED CLASSES – There are no refunds, credits, or prorating of fees for missed days, holidays or
class withdrawal.
Requirements: A signed waiver form, registration form, current immunization record and a medical
emergency form.
for all NSF checks.
MISSED CLASSES – There are no refunds, credits, or prorating of fees for missed days, holidays or
class withdrawal.
Requirements: A signed waiver form, registration form, current immunization record and a medical
emergency form.
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