REGISTRATION FORM BELOW Name * First Name Last Name Phone (###) ### #### Email * Child's Name * First Name Last Name Child's Age * Relationship to child * Preferred Enrichment (Check all that apply) Future CEO Future Author Imagination Station Reading and Media Center Fun Interactive Games Please check all that describe you Parent Grandparent Crunch Fitness Member Business Owner / Entrepreneur Educator Please type the word "YES" below to confirm that there is a first time $25 registration fee and Liability Waiver and release form required during your first visit. * Step 1: Become a Member and Choose Your Pass Option 1: Day pass Option 2: Monthly flex pass Step 2: Choose Your Creative Journey Option 1: Explore and Create on Their Own Option 2: Upgrade to our Emerging Author Journey for an additional $79, our team will guide your child through the creative process. Option 3: Upgrade to our Emerging Entrepreneur Journey for an additional $79, our team will guide your child through this framework. Are there any allergies? Are there any dietary restrictions? **Liability Waiver and Release** By signing this registration form, I, the undersigned parent or legal guardian, hereby acknowledge and agree that I am voluntarily choosing to enroll my child(ren) in The Creative Corner Kids Club ("the Club"). I understand and accept that, while the Club will take reasonable precautions to ensure the safety and well-being of my child(ren), participation in the Club’s activities may involve inherent risks, including the possibility of injury, illness, or other unforeseen events. I agree to release, waive, and discharge The Creative Corner Kids Club, its owners, employees, agents, and representatives, from any and all liability, claims, demands, or causes of action that may arise out of or relate to any loss, damage, injury, or illness, including but not limited to COVID-19 or other contagious diseases, that may occur while my child(ren) is participating in activities at the Club. I further agree that I will not hold The Creative Corner Kids Club liable or pursue any form of legal action against the Club, its owners, employees, agents, or representatives for any incident, injury, or illness that may occur while my child(ren) is in the care of the Club. I acknowledge that I have read and fully understand the terms of this Liability Waiver and Release and that I am signing it freely and voluntarily without any inducement. * Please type the word "YES" that you read Liability Waiver and Release. Is it ok to take pictures and/or video of your child when doing activities? * Yes No Thank You for Registering!Thank you so much for taking the time to complete the registration form. We’re excited to meet you and look forward to becoming a special part of your family’s journey.If you have any questions before we meet, please don’t hesitate to email us at creativecornerforkidsteam@gmail.com.We can’t wait to welcome your child(ren) to the Creative Corner Kids Club!Warm regards,Tierra Destiny Reid Director, Creative Corner Kids Club Pay Enrollment Secure Spot Here
