Row topography Shape Decorative svg added to top Toddler Play Toddler Play Wednesday 11 AM - Noon Friday 10:30 - 11:30 AM Ages: 18 months to 8 years Cost: $5.00 Toddler Play Date Attending*Name of individual participating* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Phone Number*Parent or guardian name* First Last Hold Harmless Agreement*The undersigned, in consideration of participation in this program, agrees to indemnify, defend, hold harmless and release Miss Maria’s Dance, Cheer & Gymnastics, Inc., its officers, directors, instructors, employees and/or assigns, from any and all direct or indirect liabilities, injuries and/or death, costs, damages and reasonable attorneys’ fees, which may be suffered by the below named individual registered in this program arising out of or in any way connected with participation in the program including parties and special events. I agree Date* Number of Dates You Will Be AttendingYou can pay for 1 day at a time, or multiple. Please write which days you will be coming so we know to expect you!1 Day2 Days3 Days4 Days5 Days6 Days7 DaysDays/Times You Will Be AttendingPlease write which days you will be attending. If your plans change, just let the office know! Times are Wed 10:30-11:30, Thurs 9:30-10:30, Thurs 10:30-11:15, Fri 11-11:45. Please list specific days as well. Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Expiration Date Security Code Cardholder Name
