Homeschool/Alternative PE Waitlist and Interest Form

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Hello and thank you for your interest in this program for children ages 7-12; a session under this program is typically 9 weeks long. Please answer the questions below so we that we may add you to our waitlist and offer this program at times that are more suitable to our members schedules and preferences. Our Youth Programs Manager will be contacting you to go over the programs and our waitlist procedures.

Email *

What is your child's first name?

What is your child's last name? *

What is your child's date of birth? *

YYYY

How often do you and your child come into Stone Age Climbing Gym to climb? Please mark all that apply. *

We climb occasionally using day passes

We are punch card users and come at least once a month

We are members and come to the gym regularly

We climbed in other gyms but not at Stone Age

We have been climbing mainly outside

This would be a new experience for our child

We do not climb, only our child enjoys climbing

Other:

Required

Which of the programs below - days, times per week, and gym locations - are best for your child to attend the

Mojo Rec Alternative PE program? Please mark all that apply.

Please Note that we only currently have the one offering for Alternative PE - if interest is high, we will look to add more soon!

Wednesdays at Midtown from 2:30-4:00 ($129.95 per month + Tax)

None of these (Please see next question)

Required

If you prefer another time and location, please let us know. We will consider your suggestion when creating the next session schedule.

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