Register for Learning Adventures (8-10 yrs)

Please fill in the required information below. Once form has been completed, please go to Make a Payment to complete the registration process. Submission of this form does not guarantee enrollment in the class. Once registration fee has been paid, the instructor will confirm that space is available in the class and that your child has been added to the class roster. Registration fees are non-refundable as they reserve your child’s place in the class; however, if the class is full, your registration fee will be returned.

Student's name *
Student's name
Student's birthday *
Student's birthday
Mother's name *
Mother's name
Mother's cell phone *
Mother's cell phone
Father's name
Father's name
Father's cell phone
Father's cell phone
Home address
Home address
Emergency contact *
Emergency contact
Emergency contact phone *
Emergency contact phone
I agree to submit the $25.00 registration fee with this form and understand that my child will not be enrolled until this payment is received. I agree to pay the full semester tuition, due and payable in full on or before the first day of class or I must submit a Charter School PO/voucher on or before the first day of classes. I understand that I am liable to pay any amount not covered by my charter school. *
I hereby solely and expressly assume liability for all risks and waive any claim I might have against Laura Ashmun or individuals acting in the capacity as agents of the organization (staff members, independent contractors, volunteers, etc.). I assume full legal liability for my child’s actions in class and release Laura Ashmun and all agents acting on behalf of Laura Ashmun from any claims made as a result of my actions. This release shall be effective and binding upon the parties, as well as their heirs, beneficiaries, assigns, successors and legal representatives. By checking the box, I acknowledge having read and understood this release. *
By entering your name below, you agree to the conditions set forth in this form.
Today's date *
Today's date