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FitLitKids Classes at Lakeshore Christian Fellowship Campus
Reading Giraffe is on Mondays from 1:00pm - 2:00pm
Playball is on Wednesdays from 1:00pm - 2:00pm

Wow, it's the final month of 2019! Is everyone ready to start a new decade?
Registration can be made for (a) the DECEMBER session or (b) the next class.

* Indicates required field

Student Name *

First

Last

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Age *

3 4 5

Teacher Name *

Ms. Abbey (3's) Ms. Ashley (3's) Ms. Cara (4's) Ms. Carey (3's) Ms. Haley (4's) Ms. Krista (4's) Ms. Mary (4's) Other

Primary Contact Information (Optional for returning students) *

First

Last

Phone *

Email *

Lakeshore Christian Preschool Teacher? *

Yes No

We offer Reading Giraffe and Playball, and you can register for either or both. For each program, you can register for the session (if it has already begun, we will email you the prorated amount due) or only for the upcoming class.

NOTE: If classes fill up due to monthly registrations, we will not be able to take students with the "Next Class" option.

Reading Giraffe Registration (Mondays) *

December Session: $33 (3 classes) Next Class: $11 (Register before 9am on class day.)

Playball Registration (Wednesdays) *

December Session: $33 (3 classes) Next Class: $11 (Register before 9am on class day.)

Do we have your permission to take photos/videos of your child? These will only be used on the company or school websites, or the company Facebook page, and will be without compensation. Your child’s name and identity will NOT be revealed. *

Yes No

Please list anything you'd like us to be aware of: *

Class Waiver
As a parent/guardian of a class participant, I acknowledge there are certain risks of physical injury, and I agree to assume the full risk of any injuries, damages or loss which I or my minor child/ward may sustain associated with said class. I agree to waive and relinquish all claims I or my minor child/ward may have as a result of participating in the class, against Playball, Reading Giraffe, and the city or school that hosts the class and all of their officers, agents, servants and employees.

In the event of an emergency, I authorize officials of the class to secure from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for my minor child’s/ward’s immediate care and agree that I will be responsible for payment of any and all medical services rendered, including transportation charges. My child/ward has no medical conditions that would prevent him/her from participating in the class.

Authorization *

I agree to the terms of the above waiver.

Pay for Classes Via *

Check (Please bring to pick-up.) PayPal (We will email a PayPal invoice.)

Thank you for signing up for our FitLitKids classes at the Lakeshore Christian Fellowship Campus!

You will receive a "Welcome" email when we process your registration. If you are paying via PayPal (available only for session payments), you will also receive an invoice. If you are paying via check, please bring a check to class when picking up your child.

We look forward to seeing your child in class!

We'd love to hear from you! Email, phone us, or check us out on Facebook!

Telephone

803-487-4687

email

CoachDerick@yahoo.com