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Mel's Learning Garden Class Registration
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Childs Name  *
Child's Birth Date *
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DD
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YYYY
What class(es) is your child registering for? (Be sure to choose the correct age group and session dates.) *
Required
Guardian(s) Name(s) & Phone Number(s) *
Address *
Email Address(es) for Class Info and Correspondence *
Emergency Contact Name & Number (Please List at least TWO.) *
Does your child have any allergies? If yes, please explain.  *
Is there anything else that would be helpful for me to know about your child?  
Have you read and do you agree to the following Class Attendance and Payment Policies?

This session includes classes over 5 months. Some months will have more classes than others, but will typically include 4 classes per month. 

Paying for the full session in advance is encouraged and includes a $50 discount.  If this is not possible, the full session cost is $300 divided into 5 equal payments of $60 each.

Session Pre-payment is due at time of registration. For monthly payments, the first payment is due at the time of registration and the following 4 payments are due on the 1st of each month beginning on November 1 and ending in February.  A $10 late fee is charged for payments received after the 10th of the month. 

Class attendance is important. Try to make class attendance a priority. There are no refunds for missed classes. 

If the teacher is unable to find a substitute and needs to cancel a class, there will be a make up class at an alternate day and time. 

All classes follow the Tooele School District Calendar. There are no classes held on holidays and non attendance days. There will be a few exceptions to this, so refer to the Calendar for updates. 
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I understand that Payment can be made via Venmo to @mels-learning-garden or via cash or check in person, if necessary.  Full session payment ($250) if paying advance or the first months payment ($50) are due immediately upon completing this form to hold your child's spot. *
Please read the following Accident Waiver and Release of Liability Form, then Sign and Date Below to CERTIFY THAT YOU HAVE READ THIS DOCUMENT AND FULLY UNDERSTAND ITS CONTENT, THAT YOUR ARE AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND SIGN IT OF YOUR OWN FREE WILL.

ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM

 I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH MEL’S LEARNING GARDEN, LLC,  including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

 

I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.

 

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.

 

In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

 

(A)   I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS:

          MEL’S LEARNING GARDEN, LLC

representatives, and agents, and the activity holders, sponsors, and volunteers;

 

(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

I acknowledge that they are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

 

I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.

 

I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns.

 

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

 

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

 

 

 


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