First City Gymnastics, INC
Pensacola Schools
Pace Schools
First City
Pea Ridge Bennett Russell
S.S. Dixon Primary
NB Cook - Sutter
Cordova Park Scenic Heights
Pine Meadow Lipscomb Beulah - McArthur PCA - St. Paul Brown Barge
Gymnastics
S.S. Dixon Intermediate
After school program
_
__
_
___
_ FREE transportation from your school _ girls gymnastics and boys ninja kids classes
_ homework help every day _ arts & crafts _ pit fun _ games _ rope swings _ and lots of FUN!
New this year! Aerial silks * for an extra charge * Pensacola location only _Registration fee: $60 / individual or $90 / family_
Tuition is only $71 / week 10% off for 2nd child & 25% for each additional child _ 65 E. Olive Road (850) 474-1068 / (850)736-8024-Pace _
[email protected] _ firstcitygymnastics.com
Student Agreement
Student Name_______________________________________________________D.O.B._____________ Student Name_______________________________________________________D.O.B._____________ Student Name_______________________________________________________D.O.B._____________ Mother’s Name________________________________________________________________________ Address__________________________________________City________________State/Zip_________ E-Mail______________________________Home Phone______________Cell Phone _______________ Employer Name ______________________Job Title_________________ Phone #__________________ Father’s Name_________________________________________________________________________ Address__________________________________________City________________State/Zip_________ Email ______________________________Home Phone______________Cell Phone________________ Employer Name _____________________Job Title__________________Phone#__________________ Emergency Contact ________________________Relationship_____________Phone#_______________ School your child is attending_____________________________________________________________ How did you hear about us? ______________________________________________________________
I ________________________UNDERSTAND THAT FIRST CITY GYMNASTICS IS A GYMNASTICS TRAINING CENTER AND NOT A DAYCARE IN AS SUCH, THEIR STOCK-IN-TRADE IS NOT SUPERVISION AND CARE. THEIR INTENT IS TO TEACH GYMNASTICS AND PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS. I UINDERSTAND THAT FIRST CITY GYMNASTICS IS A GYMNASTICS TRAINING CENTER AND IS A DROP-IN FACILITY, AND THAT AS SUCH, MY CHILD(REN) IS/ARE FREE TO COME AND GO. IF MY CHILD(REN) IS/ARE TO STAY AT THEIR FACILITY, IT IS BECAUSE OF MY DIRECTION AND NOT THE TRAINING CENTER’S. AUTHORIZED SIGNATURE x_______________________________________________________Date______________________ WAIVER & RELEASE: You, Buyer and Student, agree that you are aware that Student is engaging in physical exercise and the use of equipment, use of First City Gymnastics’ facilities and instruction, which can be dangerous to the Student and could cause injury to Student. Student is voluntarily participating in these activities and Buyer and Student assume all risks of injury to Student, which may result. Buyer and Student hereby waive and release any claim or right to sue First City Gymnastics, employees or agents for injury to Student, which may result. Buyer and Student have carefully read this waiver and release and fully understand it is a release of all liability and damage of First City Gymnastics for any injury. First City Gymnastics will make no evaluation or recommendation whether Student of guests are sufficiently physically fit for any exercise activities. It is always advisable to consult your physician before undertaking a physical exercise program, particularly gymnastics activities. LOSS/DAMAGE/THEFT OF STUDENT’S PROPERTY: First City Gymnastics does not assume any responsibility for the loss, damage or theft of any property belonging to the Student. Student agrees that First City Gymnastics and its personnel are not responsible to, or liable for, any such property even if its loss, damage, or theft occurs on or about First City Gymnastics’ facility.
PARENTS – PLEASE LIST ANY PERSONS EVER ALLOWED TO PICK UP YOUR CHILD(REN). ______________________________ ______________________________ ______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
First City Gymnastics, Inc Payment Policies All payments will be made electronically on the Friday morning preceding the week of attendance. If you wish to pay with some other form of payment than what we have on file, you must pay on Thursday. Tuition is $71.00/week. A 10% discount for the 2nd child & 25% discount for 3rd & 4th child. A Registration Fee of $60.00/child or $90.00/family is due each school year. • If you plan on splitting the payments between 2 parents we will do it on a weekly basis. We will not alternate weeks from parent to parent. Each week the charge for each parent will be split accordingly. • There is a $25.00 service charge for any declined credit or debit card or if a payment is not received by Friday morning. • If any payment is not made by the due date, we cannot provide services until payment is made. • A two-week notice is required prior to termination of your child’s attendance in the After-School Gymnastics Program. You will be charged for those two weeks. There will be no terminations the month of May. • NOTE: NO REFUNDS. Credits for attendance are only issued if a student is absent for one full week in the AfterSchool Gymnastics Program with a doctor’s note, OR if the director is notified in writing in advance of the absence. Credits for partial week attendance or national holidays will not be issued. We also do not credit or refund for unscheduled school closings due to weather events. • Because we are a full-time afterschool care provider, you will be charged the full weekly price regardless of how many days a week your child attends afterschool care. ___________ Initial
• •
Pick-up Policies Pick-up time is 6:00 p.m. There is a late pick-up fee of $15.00 per every 15 minutes. Please be prepared to pay upon pick-up. NO EXCEPTIONS. NO EXCUSES.
__________ Initial
• • • • •
Parent Responsibilities for After-School Notify Teachers that your child will be doing afterschool care with First City Gymnastics. Notify the school office that your child is in line for the van to First City Gymnastics Program OR the appropriate bus number. (This depends on which school your child attends. Ask your After-School Gymnastics Program director for more information) If your child is 5 or younger you must provide us with a booster seat for the van. This rule is required by law. Please call the First City Gymnastics by NOON if your child WILL NOT be attending on a regularly scheduled day, 850-474-1068. Please send a snack with your child every day and/or put money in an account for them to use at the snack bar.
__________ Initial
•
• • •
Clothing The dress code for any day your child has class or open gym will be: Girls – leotard or athletic shorts and First City t-shirt (green, red, or purple). PLEASE KEEP EXTRA HAIR TIES in your CHILD’S BAG! Boys – Athletic shorts and Ninja Shirt on class days. On free gym days, they may wear their Ninja Shirt or First City Shirt If your child does not have appropriate clothing your account will be charged and your child will be issued clothes (the cost of the First City t-shirts will be $15). Each child will be issued a cubby to keep their clothes in for the week. CLOTHING MAY NOT HAVE ANY BUTTONS, ZIPPERS OR BUCKLES (THESE ITEMS TEAR UP THE EQUIPMENT)!!!
___________ Initial
Closing Dates •
First City will be CLOSED the following dates. We WILL NOT provide care on these dates & you will not be charged: September 4th (Labor Day) November 20th-24th (Thanksgiving)
____________ Initial
December 25th-29th (Christmas) May 28th (Memorial Day)
January 1st (New Year’s Day)
RELEASE FOR EMERGENCY CARE This form must contain only one child’s name, be notarized and updated annually I hereby give my consent to any emergency facility and physician to administer necessary treatment to my Child/ren_______________________________ in the event of an emergency at which time that I cannot be reached. I give consent to transport by ambulance if situation warrants it.
_______________________________________________ Family Physician’s Name/Health Care Resource
___________________________ Telephone Number
Allergies: ______________________________________________________________________________ Date of Last DPT or Tetanus: _______________________________________________________________ Insurance Company covering child: __________________________________________________________ Policy Number: ______________________________ Group No. __________________________________
_____________________________________________________ Signature of Custodial Parent/Legal Guardian
Phone Number: (H) _____________________________
___________________________ Date
(W) ___________________________________
Emergency Contact: ______________________________________________________________________ Name Area Code, Telephone Number _____________________________________________________________________ Street Address (number, apartment, street) City, State, Zip
STATE OF __________________________ COUNTY OF________________________ The foregoing instrument was acknowledged before me this __________ day of ______________ 20____by ___________________________________, who is personally known to me or who has produced ___________________________________ as identification and who did (did not) take an oath. Signed: __________________________________ __________________________________ Name – typed, printed or stamped
__________________________________ Title or Rank
____________________________ Serial Number (if any)
First City After-School Gymnastics Program Payment Information Student Name(s)_______________________________________________________ Mom’s Name______________________Dad’s Name_________________________
For Office Use Only Annual Registration Fee $ 60 individual/ $ 90 family Registration Amount________________Date Paid_________________
ELECTRONIC PAYMENT INFORMATION - MOM Weekly tuition (Full Payment Required) $_________ Method of Electronic Payment (please mark one)
_____Visa _____MasterCard _____Discover Name on Credit Card: __________________________________________ Card Number: ________________________________sec. code________ Exp. Date_____________ Zip code of billing___________ Signature_______________________________________
ELECTRONIC PAYMENT INFORMATION - DAD Weekly tuition (Full Payment Required) $_________ Method of Electronic Payment (please mark one)
_____Visa _____MasterCard _____Discover Name on Credit Card: __________________________________________ Card Number: ________________________________sec. code________ Exp. Date_____________ Zip code of billing___________ Signature_______________________________________
Pace Schools
First City
Pea Ridge Bennett Russell
S.S. Dixon Primary
NB Cook - Sutter
Cordova Park Scenic Heights
Pine Meadow Lipscomb Beulah - McArthur PCA - St. Paul Brown Barge
Gymnastics
S.S. Dixon Intermediate
After school program
_
__
_
___
_ FREE transportation from your school _ girls gymnastics and boys ninja kids classes
_ homework help every day _ arts & crafts _ pit fun _ games _ rope swings _ and lots of FUN!
New this year! Aerial silks * for an extra charge * Pensacola location only _Registration fee: $60 / individual or $90 / family_
Tuition is only $71 / week 10% off for 2nd child & 25% for each additional child _ 65 E. Olive Road (850) 474-1068 / (850)736-8024-Pace _
[email protected] _ firstcitygymnastics.com
Student Agreement
Student Name_______________________________________________________D.O.B._____________ Student Name_______________________________________________________D.O.B._____________ Student Name_______________________________________________________D.O.B._____________ Mother’s Name________________________________________________________________________ Address__________________________________________City________________State/Zip_________ E-Mail______________________________Home Phone______________Cell Phone _______________ Employer Name ______________________Job Title_________________ Phone #__________________ Father’s Name_________________________________________________________________________ Address__________________________________________City________________State/Zip_________ Email ______________________________Home Phone______________Cell Phone________________ Employer Name _____________________Job Title__________________Phone#__________________ Emergency Contact ________________________Relationship_____________Phone#_______________ School your child is attending_____________________________________________________________ How did you hear about us? ______________________________________________________________
I ________________________UNDERSTAND THAT FIRST CITY GYMNASTICS IS A GYMNASTICS TRAINING CENTER AND NOT A DAYCARE IN AS SUCH, THEIR STOCK-IN-TRADE IS NOT SUPERVISION AND CARE. THEIR INTENT IS TO TEACH GYMNASTICS AND PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS. I UINDERSTAND THAT FIRST CITY GYMNASTICS IS A GYMNASTICS TRAINING CENTER AND IS A DROP-IN FACILITY, AND THAT AS SUCH, MY CHILD(REN) IS/ARE FREE TO COME AND GO. IF MY CHILD(REN) IS/ARE TO STAY AT THEIR FACILITY, IT IS BECAUSE OF MY DIRECTION AND NOT THE TRAINING CENTER’S. AUTHORIZED SIGNATURE x_______________________________________________________Date______________________ WAIVER & RELEASE: You, Buyer and Student, agree that you are aware that Student is engaging in physical exercise and the use of equipment, use of First City Gymnastics’ facilities and instruction, which can be dangerous to the Student and could cause injury to Student. Student is voluntarily participating in these activities and Buyer and Student assume all risks of injury to Student, which may result. Buyer and Student hereby waive and release any claim or right to sue First City Gymnastics, employees or agents for injury to Student, which may result. Buyer and Student have carefully read this waiver and release and fully understand it is a release of all liability and damage of First City Gymnastics for any injury. First City Gymnastics will make no evaluation or recommendation whether Student of guests are sufficiently physically fit for any exercise activities. It is always advisable to consult your physician before undertaking a physical exercise program, particularly gymnastics activities. LOSS/DAMAGE/THEFT OF STUDENT’S PROPERTY: First City Gymnastics does not assume any responsibility for the loss, damage or theft of any property belonging to the Student. Student agrees that First City Gymnastics and its personnel are not responsible to, or liable for, any such property even if its loss, damage, or theft occurs on or about First City Gymnastics’ facility.
PARENTS – PLEASE LIST ANY PERSONS EVER ALLOWED TO PICK UP YOUR CHILD(REN). ______________________________ ______________________________ ______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
First City Gymnastics, Inc Payment Policies All payments will be made electronically on the Friday morning preceding the week of attendance. If you wish to pay with some other form of payment than what we have on file, you must pay on Thursday. Tuition is $71.00/week. A 10% discount for the 2nd child & 25% discount for 3rd & 4th child. A Registration Fee of $60.00/child or $90.00/family is due each school year. • If you plan on splitting the payments between 2 parents we will do it on a weekly basis. We will not alternate weeks from parent to parent. Each week the charge for each parent will be split accordingly. • There is a $25.00 service charge for any declined credit or debit card or if a payment is not received by Friday morning. • If any payment is not made by the due date, we cannot provide services until payment is made. • A two-week notice is required prior to termination of your child’s attendance in the After-School Gymnastics Program. You will be charged for those two weeks. There will be no terminations the month of May. • NOTE: NO REFUNDS. Credits for attendance are only issued if a student is absent for one full week in the AfterSchool Gymnastics Program with a doctor’s note, OR if the director is notified in writing in advance of the absence. Credits for partial week attendance or national holidays will not be issued. We also do not credit or refund for unscheduled school closings due to weather events. • Because we are a full-time afterschool care provider, you will be charged the full weekly price regardless of how many days a week your child attends afterschool care. ___________ Initial
• •
Pick-up Policies Pick-up time is 6:00 p.m. There is a late pick-up fee of $15.00 per every 15 minutes. Please be prepared to pay upon pick-up. NO EXCEPTIONS. NO EXCUSES.
__________ Initial
• • • • •
Parent Responsibilities for After-School Notify Teachers that your child will be doing afterschool care with First City Gymnastics. Notify the school office that your child is in line for the van to First City Gymnastics Program OR the appropriate bus number. (This depends on which school your child attends. Ask your After-School Gymnastics Program director for more information) If your child is 5 or younger you must provide us with a booster seat for the van. This rule is required by law. Please call the First City Gymnastics by NOON if your child WILL NOT be attending on a regularly scheduled day, 850-474-1068. Please send a snack with your child every day and/or put money in an account for them to use at the snack bar.
__________ Initial
•
• • •
Clothing The dress code for any day your child has class or open gym will be: Girls – leotard or athletic shorts and First City t-shirt (green, red, or purple). PLEASE KEEP EXTRA HAIR TIES in your CHILD’S BAG! Boys – Athletic shorts and Ninja Shirt on class days. On free gym days, they may wear their Ninja Shirt or First City Shirt If your child does not have appropriate clothing your account will be charged and your child will be issued clothes (the cost of the First City t-shirts will be $15). Each child will be issued a cubby to keep their clothes in for the week. CLOTHING MAY NOT HAVE ANY BUTTONS, ZIPPERS OR BUCKLES (THESE ITEMS TEAR UP THE EQUIPMENT)!!!
___________ Initial
Closing Dates •
First City will be CLOSED the following dates. We WILL NOT provide care on these dates & you will not be charged: September 4th (Labor Day) November 20th-24th (Thanksgiving)
____________ Initial
December 25th-29th (Christmas) May 28th (Memorial Day)
January 1st (New Year’s Day)
RELEASE FOR EMERGENCY CARE This form must contain only one child’s name, be notarized and updated annually I hereby give my consent to any emergency facility and physician to administer necessary treatment to my Child/ren_______________________________ in the event of an emergency at which time that I cannot be reached. I give consent to transport by ambulance if situation warrants it.
_______________________________________________ Family Physician’s Name/Health Care Resource
___________________________ Telephone Number
Allergies: ______________________________________________________________________________ Date of Last DPT or Tetanus: _______________________________________________________________ Insurance Company covering child: __________________________________________________________ Policy Number: ______________________________ Group No. __________________________________
_____________________________________________________ Signature of Custodial Parent/Legal Guardian
Phone Number: (H) _____________________________
___________________________ Date
(W) ___________________________________
Emergency Contact: ______________________________________________________________________ Name Area Code, Telephone Number _____________________________________________________________________ Street Address (number, apartment, street) City, State, Zip
STATE OF __________________________ COUNTY OF________________________ The foregoing instrument was acknowledged before me this __________ day of ______________ 20____by ___________________________________, who is personally known to me or who has produced ___________________________________ as identification and who did (did not) take an oath. Signed: __________________________________ __________________________________ Name – typed, printed or stamped
__________________________________ Title or Rank
____________________________ Serial Number (if any)
First City After-School Gymnastics Program Payment Information Student Name(s)_______________________________________________________ Mom’s Name______________________Dad’s Name_________________________
For Office Use Only Annual Registration Fee $ 60 individual/ $ 90 family Registration Amount________________Date Paid_________________
ELECTRONIC PAYMENT INFORMATION - MOM Weekly tuition (Full Payment Required) $_________ Method of Electronic Payment (please mark one)
_____Visa _____MasterCard _____Discover Name on Credit Card: __________________________________________ Card Number: ________________________________sec. code________ Exp. Date_____________ Zip code of billing___________ Signature_______________________________________
ELECTRONIC PAYMENT INFORMATION - DAD Weekly tuition (Full Payment Required) $_________ Method of Electronic Payment (please mark one)
_____Visa _____MasterCard _____Discover Name on Credit Card: __________________________________________ Card Number: ________________________________sec. code________ Exp. Date_____________ Zip code of billing___________ Signature_______________________________________
