Enrollment Form for Ages 2-5

Child's Full Name *

First

Last

School *

Address *

City *

State *

Zip Code *

Phone Number *

Parent's Name

First

Last

Email *

Child's Age *

Date of Birth *

If you agree to the below content regarding the release of claims and liability of any kind of personal injury, please type the word AGREE (all caps) in the box below. *

By submitting this form, I give permission for my child to participate in JUMP-N-FUN and hereby release JUMP-N-FUN from any and all claims and liability of any kind of personal injury that may result from my child's participation. I acknowledge that my child has been cleared by a family/pediatric physician to participate in this activity.

If you agree to the below content regarding your child's photos being used for promotional purposes, please type the word AGREE (all caps) in the box below. Otherwise, type DISAGREE in the box below. *

By typing AGREE in the above box, I give permission for my child's photo/likeness to be used in Jump-N-Fun promotional, social media, and web content.

Today's Date *

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