Jiggle Parents Night Out RSVP
Event Address: 889 4th Ave, Brooklyn, NY 11232
Contact us at: +1(347-461-2200) or jigglegymstudio@gmail.com
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Parent Information & Event Details 
Kids ages 4-10 only
Name and Age of Child Attending (Siblings, please list both names and ages) *
Emergency Contact Name
*
Emergency Contact Phone Number  *
Emergency Contact Email  *
How did you hear about this event? *
Pizza will be provided. However, you are welcome to pack a meal for your child if needed. *
Extended Pick Up Available until 9:30 pm. *
Please let us know if there’s anything else we should be aware of.
RISK AND WAIVER OF LIABILITY.
As the parent or guardian of the above referenced child(ren), I hereby give permission for our child(ren) to participate in Parents Night Out at Jiggle Studio. I recognize that this is a drop-off event that includes group games, team challenges, free play, pizza dinner, and cool-down activities, and that there are inherent risks involved in active play.
On behalf of my child and on our own behalf, I agree to waive all claims against Jiggle Studio and its owners, staff and instructors for any liability, loss, cost, damage, medical expense, long-term care or emotional distress arising out of any personal injury, including total disability, paralysis and death, which may occur to any of the children while on the premises of or under the instruction, supervision, or control of Jiggle Studio. This indemnification extends to any court costs, legal fees, attorney fees, and administrative costs associated with such claims. I hereby testify to my child’s sound health of mind and body and authorize Jiggle Studio to seek medical treatment at the nearest medical facility in case of emergency.
I hereby grant consent and authorize the use of photographs, slides, video recordings of my child participating in Jiggle Studio activities for commercial and purposes in any medium of advertising, communication, publication or publicity that will promote Jiggle Studio programs, and/or recognition of participants.
I have read and understand all the above and agree to the above terms, including the Risk and Waiver of Liability.

Please type your full name below to acknowledge that you have read and agree to the above waiver.

*
Discount codes:Bringing a friend use code PLUS1  Sibling use code 2ndChild
REQUIRED:  If using code PLUS1 please list friend's name below.
If signing up more then 2 Siblings please repeat the checkout transaction for 3rd child using the sibling discount code
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