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Bricks 4 Kidz - Registration Form
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Chosen class or camp schedule/s:
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Participant's Name
(This question is mandatory)
Date of Birth
Open the date time chooser

Format: mm/dd/yyyy

School
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Parent/Guardian Name
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Address
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City
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Email Address
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Retype Email Address
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I would like to receive updates and helpful tips from Bricks 4 Kidz
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DOES THE PARTICIPANT HAVE ANY ALLERGIES OR MEDICAL CONDITION?
(This question is mandatory)
KINDLY DESCRIBE
(This question is mandatory)
Emergency Contact Information
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(PHOTO RELEASE) I consent to Bricks 4 Kidz’s use of any photographs or video recording that are taken of my child while participating in the camp activity for use in Bricks 4 Kidz brochures and program materials that are distributed both as printed document and on the internet. No payment will be made for use of these photographs and/or videos. Your child’s name would never be used in connection with these images.
(This question is mandatory)

 

My child's participation in the camps selected is voluntary. I understand that the selected activities may involve accidental injury and hereby voluntarily assume such risks. Knowing these risks, I want my child to participate in this activity. I (on behalf of my child) hereby assume the risk, and hereby waive, release, and discharge Bricks 4 Kidz®., its officers, employees, activity instructors and assistants, and all officers and employees of the school or community center sites where said activity will take place, for any and all claims for damages for personal injuries, or claims for damages to property, which my child or my child's heirs, assigns, executors or administrators may have or which may accrue to my child's participation in this activity. I have read the above and understand important legal rights are being waived.

 

Cancellation and Refund Policy

Bricks 4 Kidz reserves the right to cancel any program schedule due to insufficient enrollment.  Upon cancellation a full refund will be made. Registered participants will be notified via SMS.

Refunds will not be issued for non-attendance at a scheduled class.