Class Registration WINTER 2020
Winter 2020 (10 weeks) January 8th - March 14th
bebenatura.us@gmail.com
* Required
Email address
*
Your email
Student Name:
*
Your answer
Child's Bithday:
Your answer
Sibling Name:
Your answer
Sibling's Birthday:
MM
/
DD
/
YYYY
Parent's Name:
*
Your answer
Mailing Address:
*
Your answer
Phone- Home:
Your answer
Phone- Cell:
*
Your answer
Emergency Contact:
*
Your answer
Emegency Phone:
*
Your answer
New Student?
*
Yes
No- Returning Student
One Trial Class Purchase Only (no session registration) Date/Class/Time
*
Your answer
Class Name and Time Locations: (WS-West Seattle/ Ren-Renton)
*
Baby Class Wednesday WEST SEATTLE 10:45- 11:45 am ($196)
Baby Class Saturday WEST SEATTLE 1:45- 2:45 pm ($196)
Baby Class Thursday RENTON 12:00- 1:00 pm ) ($196)
Waddler/Toddler Class Wednesday WEST SEATTLE 9:30-10:30 am ($196)
Waddler/Toddler Class Saturday WEST SEATTLE 3:00- 4:00 pm ($196)
Waddler/Toddler Class Thursday RENTON 10:45-11:45 am ($196)
Other Fees:
*
Non-Refundable Registration Fee $10
One Time Parent Pack Fee $35 - New students only
Trial Class Only $15
Required
Promo Code:
Your answer
I understand that I will be invoiced for payment within 48 hours
*
Yes
Other:
Required
Photo Waiver: The undersigned agrees to release Bebe Natura, its officers, agents, and employees, from any and all claims, suits, actions, damages, or compensation in any way related to the use and reproduction on photograph(s) taken of me or my child which are used in media publications exclusively for Bebe Natura.
*
Yes
Please check if you or your child don't want to me photographed.
Other:
Required
Liability Waiver: I agree to the participation in the Nurturing Pathways®, Inc. Program for myself and my child(ren). I am aware that the activities of creative movement involve risks for myself and my child(ren). I hereby release Nurturing Pathways®, Inc. from any legal liability and agree not to sue its owners, officers, directors, and employees for any and all injuries caused my participation in the class. I have read and understand the tuition, refund, and missed class policies. Signature: (Please type full name)
*
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms