Developing Critical Thinkers of Today and Tomorrow
______
1423 JULIA STREET ♦ FERNANDINA BEACH, FL 32034 ♦ 904.261.6610 ♦ FAX 904.261.6196

Fun Fitness Registration & Permission Form (K-6th Grade)

Beginning Friday, September 12, 2014

3:10 PM – 4:10 PM, Playground (location TBD in Inclement Weather)

Instructor: Cliff Drysdale Tennis Instructors

Student’s Name: ______Age: ______

Teacher: ______Parent’s Name: ______

E-mail: ______Cell Phone Number: ______

Details:

·  Cost for the 11-week studio is $132.00.

·  Class duration is 60 minutes.

·  All instructors have been through the AIMS background check and county requirements.

·  Please ensure that your child wears appropriate clothing and shoes for physical exercise and has a water bottle.

·  If someone other than a parent/guardian will be authorized to pick up the child, please make note on bottom of registration form in space provided.

·  Your child will need to be signed out each day to ensure safety for all participants.

·  The emergency card on file at school is what will be used if the need arises. Please update with current information if needed.

·  Please be prompt in picking up your child. Children not picked up on time will be brought to the After School Program and parents will be charged accordingly. Please pick up your child from the classroom the studio is being held in.

Payment:

Payment is due at time of registration and must be paid by Friday, September 5, 2014 via cash or check. Checks should be made payable to Amelia Island Montessori School (AIMS). Refunds will not be given for lessons not attended by participant. If the class is cancelled due to weather or unforeseen circumstances, a make-up class will be scheduled. Communication of any cancellations will come via email to the address we have on file at the school.

Permission to Participate:

I consent for my child to participate in Fun Fitness Studio, sponsored by Amelia Island Montessori School. I agree to assume all the risks and hazards incidental to said participant and do further agree to release, absolve, indemnify, and otherwise hold harmless Amelia Island Montessori School, its employees, administrators, agents, assigns, and others who assist the above for any loss, damages, or personal injuries that my child may receive as a result of such participation. I hereby agree to waive all claims against Amelia Island Montessori School, its employees, administrators, and agents.

______

Parent’s Signature Date

Notes for Instructor or School:

______

Other Adults Authorized to pick up my child:

Name: / Relationship to Child: / Contact Number: / Dates Authorized:

“