Child's Birthdate

MM

DD

YYYY

Graduation/End Date (if known)

You can cancel at any time, but if you already know when you'll be leaving, we can set your plan to end accordingly.

MM

DD

YYYY

Phone *

(###)

###

####

Add'l Phone (opt.)

(###)

###

####

Terms of Service *

I understand that the RockStarts® Curriculum is taught every week that that the center is open. In the rare occasion that a teacher is absent and a sub is unavailable, that class will be moved to a different date. No pro-rations or refunds will be made for student absence. I do hereby consent and agree that RockStarts® has the right to take photographs and video of my child during classes, if my child's center so permits. These photos and video may be used on the company website, company Facebook pages, and promotional material without compensation, but my child's name and identity will not be revealed. I will notify RockStarts via e-mail at classes@rockstarts.com if I would like my child's images to remain private. I understand my child's enrollment will be effective as of this registration date. I will contact classes@rockstarts.com if I need to alter my enrollment (e.g., if my child leaves the center), and will contact my center directly with any billing questions.

I accept these Terms of Service.

Waiver of Liability *

The RockStarts® Curriculum is active and interactive, and often guides students through large movements including jumping, spinning, running, and gentle tumbling. Although many risks can be avoided, I understand that not all risks can be and release RockStarts® from responsibility for any injury that my child might incur during the course of the classes. In the extremely rare event of a medical emergency, my child's center will follow its own procedures for obtaining medical assistance and I release RockStarts® Atlantic, LLC from any liability or responsibility thereto. In consideration of participation in the RockStarts® weekly classes, on behalf of myself, my family, my heirs, and my assigns, I hereby release RockStarts® Atlantic, LLC, and any of its licensors, agents, contractors, and employees from liability for injury, loss, or death to the above-mentioned participant while using any facility or equipment or in any way associated with participating in the RockStarts® classes now or in the future.

I consent to the RockStarts® Waiver of Liability.

Payment Authorization *

I understand that The Young Schools will incorporate this class into my tuition, starting with the first class after this registration date and ending either on the end date given above or when I notify RockStarts® that my child will be leaving the program.

I authorize automatic monthly payments to Young School for the RockStarts® program.