Kids and Art - teaching kids thru art and imagination
Jump-N-Art
Registration
Registration Information
*Required Field
*Parent/Guardian Name(s):
*Child's Name:
Birth Date:
T-Shirt Size:
*
Child's Name:
Birth Date:
T-Shirt Size:
*
Child's Name:
Birth Date:
T-Shirt Size:
*
Child's Name:
Birth Date:
T-Shirt Size:
*
Child's Name:
Birth Date:
T-Shirt Size:
*
*Email Address:
  *T-Shirt sizes are applicable only for summer registration.
*Free while supplies last only
*Address:
City:
Zip:
Input any friends to group your child with (if applicable):
*Groups are done by age and if children requested do not fall in the same age category they may not be grouped together for safety reasons.
Other authorized adults for pick up:
 
*Best phone number to reach you at:
   
Alternate number:
   
 
*Emergency contact other than yourself (name and number):
 

Do you authorize a staff member to call 911 or take your child to the nearest hospital if an emergency were to occur?   
Yes No
 

Does your child have any allergies or special needs? If so, please list them below:
Select program registering for:  Summer Camp  Thanksgiving Camp  Holiday Camp  Spring Break Camp Other
If your child is a current 2011 camper check here:
 
*Where did you hear about us?
 
Enter any promotional discounts, if applicable:
*Select Location:
Frisco
 

*For Summer Camps, input how many weeks?

*For Summer Campes, Input dates selected here:

  *Registration Notes:
Payment Information
*Payment type:
Visa        Mastercard
*Card Number:
- - -
*3 digit security code: (on back of card)
*Expiration Date:
Reminder: there is a one time $25 registration fee (applied during the summer only EVERY summer) per child. If your child is a current 2011 camper this will not apply (1st time registration only.)
 
I have read and understand the refund/change policy.
 
I have read and understand the camp guidelines.
*Digital Signature for Payments:
By digitally signing here you agree to camp fees, any registration fees as well as late pick up fees that may apply.
 

In consideration of being allowed to enter into the play arena and/or participate in any party and/or program at Pump It Up, the undersigned, on his or her behalf, and on behalf of participant(s) identified above, acknowledges, appreciates and agrees to the following conditions:

I represent that I am the parent or legal guardian of the participant(s) named below, or I have obtained permission from the parent/legal guardian of the participant(s) named below to execute this agreement on their behalf. I agree that the participant(s) named below and I shall comply with all stated and customary terms, posted safety signs, rules and verbal instructions as conditions for participation in any party and/or program at Pump It Up. In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest Pump It Up employee or official immediately;

I am aware that there are inherent risks associated with participation in Pump It Up programs, parties and/or use of the play area and inflatable equipment and I, on behalf of myself and the participant(s) named below, knowingly and freely assume all such risk, both known and unknown, including those that may arise out of negligence of other participants; and;

I for myself and the participant(s) named below, and our respective heirs, assigns, administrators, personal representatives, and next of kin hereby release and hold harmless Leigh King, L.P., d/b/a Pump It Up, and PIU Management, LLC, their affiliates, officers, members, agents, employees, other participants and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to our participation in any and all Pump It Up programs, activities, parties, the use of the play area and/or inflatable equipment. This waiver is valid during the participant(s) listed enrollment.

Digital Signature:
By signing this waiver you also give permission to Creative Kids Club to photograph your child for the camp website and promotional uses. If you do not wish for your child(ren) picture to be used in any manner, please check here:

 
 
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