Class Registration Fall 2019
Fall 2019 October 18th - December 21st
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:
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Your answer
Phone- Home:
Your answer
Phone- Cell:
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Your answer
Emergency Contact:
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Your answer
Emegency Phone:
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Your answer
New Student?
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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 RENTON 12:00- 1:00 pm ($196)
Baby Class Sat WEST SEATTLE 1:45- 2:45 pm ($196)
Waddler Class Wednesday RENTON 9:45- 10:30 ($196)
Toddler Class Wednesday RENTON 10:45- 11:45 am ($198)
Waddler/Toddler Class Sat WEST SEATTLE 3:00- 4:00 pm ($198)
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
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