Babysitting/CPR Workshop Sign Up (Sat June 27)

Child's Name

First NameLast Name

Child's Date of Birth

Date

Parent/Guardian Full Name

First NameLast Name

Parent/Guardian Email Address

example@example.com

Parent/Guardian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Does your child have any allergies or medical conditions? Please specify.

Are there any special needs or accommodations required for your child?

WAIVER AND RELEASE: I, the parent and/or legal guardian of Student, in consideration of the Student’s enrollment and participation in English in Five, LLC, a Florida limited liability company d/b/a North Palm Classes (hereinafter referred to as “NPC” and the “Company”), hereby give permission for the Student to participate fully in all of NPC’s activities. As part of this permission:A. I hereby consent to have photographs (including video) and/or audio recordings made of the Student by NPC. Further, NPC has my permission to use the Student’s image in any form of marketing (brochure, website, television, newspaper, social media such as Facebook, Instagram, Youtube, or Tiktok, etc.) for the purpose of promotion and publicity of NPC. I waive all claims for compensation for the use of the photographs and audio content and I hereby release all members of NPC and each and every one of its officers, directors, partners, shareholders, employees, agents, insurers, affiliates, successors in interest, attorneys, or any other person or persons associated with any or all of them or any variation in the name of any or all of them who might be liable from any claim or liability arising from the taking or use of photographs, recordings and interviews.B. I acknowledge and agree that should an emergency arise, I will be notified immediately. However, in the event that I cannot be located immediately, I grant NPC the right to authorize emergency medical treatment for the Student in the event that I, or my emergency contact(s), cannot be reached. I further acknowledge and understand that the Student may engage in activities that involve risk of serious injury, including permanent disability or death and severe social and economic losses which might result not only from the Student’s own actions, inactions, or negligence, but the actions, inactions, or negligence of others, or the conditions of the premises or of any equipment used, and further, that there may be other unknown risks not reasonably foreseeable at this time. I hereby assume all the foregoing risk and accept personal responsibility for any damages following such injury, permanent disability, or death, and hereby forever release, discharge, covenant to indemnify and not to sue NPC and each and every one of its officers, directors, partners, shareholders, employees, agents, insurers, affiliates, successors in interest, attorneys, or any other person or persons associated with any or all of them or any variation in the name of any or all of them who might be liable by NPC, from any claims or liability by or on behalf of me or the Student relative to the health, sickness and treatment of the Student.C. I further forever release, discharge, covenant to indemnify and not to sue NPC and each and every one of its officers, directors, partners, shareholders, employees, agents, insurers, affiliates, successors in interest, attorneys, or any other person or persons associated with any or all of them or any variation in the name of any or all of them who might be liable by NPC, from any claims or liability by or on behalf of me or the Student as a result of the Student’s participation in NPC’s program (including without limitation, personal injury, property damage, or death), either directly or indirectly.D. I sign this Accident Waiver and Release of Liability on my own and on behalf of the Student. I have read this Accident Waiver and Release and understand that by signing it, I give up substantial rights I and/or the Student would otherwise have to recover damages for losses occasioned by NPC’s fault, and sign it voluntarily and without inducement.

Refund/cancellation policy - Registration for all kids programs must be completed online in advance. Those who elect to register in person at the time of the event do so with the understanding that enrollment is not guaranteed; priority will be given to those who pre-registered online, and entry will only be permitted if space remains available. Cancellations made at least 24 hours prior to the scheduled event start time will receive a credit to their account, applicable toward a future class. Cancellations made less than 24 hours before the event start time are not eligible for a credit or refund. North Palm Classes staff reserve the sole right to make exceptions to this policy at their discretion. Please note that there will be a minimum enrollment of 7 students. Registrants will be notified and refunded if the event doesn't run.

Please check the box of the class you are signing up for:

Toddler Craft Club

Babysitting/CPR Workshop

Includes 3 certifications: AHA CPR, HSI Child & Babysitting Safety, and Master of Babysitting ACE, plus lunch and all materials.

$150.00 Quantity

Total

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