Registration Form

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Registration Form

Please fill out the information below for the children you have that will be enrolling in Balance Beans programs.

* Indicates required field

Child Name *

First

Last

Please enter first and last name of your child.

Second Child's Name *

First

Last

If you have a second child enrolling in Balance Beans, please enter his or her name here.

Third Child's Name *

First

Last

If you have a third child enrolling in Balance Beans, please enter his or her name here.

Parent Name *

First

Last

Parent Phone Number *

Parent Email *

I certify that the following statements are true and accurate. *

I am the legal guardian of the child (children) above. I give my permission for my child (children) to be photographed or videographed for Balance Beans marketing purposes. I will not hold Balance Beans, its owners or staff liable for any injuries my child (children) sustains during this program. I certify that I have read and agree to all the policies post on the Policies page.

MOON BEANS *

Tuesday Girls Gymnastics Tuesday Preschool Thursday Preschool Thursday Girls - 9am Thursday Preschool Thursday Girls - 11am Thursday Evening Preschool Thursday Evening Girls

List Health Conditions Your Child (Or Children) Has *

Please note any physical restrictions or health issues that the instructor should be aware of.

Submit

Telephone

618-978-2588

Email

[email protected]

Welcome
Products
About Me
Contact
Resources
As Seen On Pinterest
What To Buy