Registration Form

Please fill out the information below for the children you have that will be enrolling in Balance Beans programs.

* Indicates required field

Child Name *

First

Last

Second Child's Name *

First

Last

Third Child's Name *

First

Last

Parent Name *

First

Last

Parent Phone Number *

Parent Email *

I certify that the following statements are true and accurate. *

I am the legal guardian of the child (children) above. I give my permission for my child (children) to be photographed or videographed for Balance Beans marketing purposes. I will not hold Balance Beans, its owners or staff liable for any injuries my child (children) sustains during this program. I certify that I have read and agree to all the policies post on the Policies page.

If enrolling in Moon Beans please select the appropriate class. *

Mom and Tot Preschool Girls Gymnastics Monday Morning Mom and Tot

Name of Your Child's Daycare or Location of Class *

Child's Teacher or Class Room Name (if applicable) *

List Health Conditions Your Child (Or Children) Has *

Submit