Child's Name *

First Name

Last Name

Child's Date of Birth (children must turn 3 by December 31, 2026 to enroll in this class) *

MM

DD

YYYY

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian's Phone Number *

(###)

###

####

Which class would you like to enroll your child in? *

Monday/Wednesday/Friday 9am to 12pm class for 3 to 5 year olds (child should turn 3 by 12/31/26 to join this class)

Are your child's immunizations up to date? *

We do require that all students are up-to-date with their immunizations in order to participate in the classes. We will require a copy of your child's immunization records prior to the first day of the session. Please either email a copy of your child's records to info@creativegroovestudio.com or bring a copy of them to the first class.

Yes

No

Refund Policy *

When you register, you are committing for the full school year. If your plans change and you want to cancel your registration before February 1, 2026, we will issue a full refund. We do not offer a refund after February 1, 2026 if you need to withdraw your child's enrollment.

I have read and accept the Refund Policy

Waiver - please read and check "I accept" box* *

Please read the information below and then sign the agreement by typing your name in the box below: LIABILITY AND ASSUMPTION OF RISK I understand that my child will be attending Creative Groove Studio classes at Mile Square Theatre (1400 Clinton Street, Hoboken) at his, her or my own risk and I will not hold the officers, directors, independent contractors, volunteers, or employees of The Creative Groove Studio, LLC or Mile Square Theatre responsible for any injuries or damages received by the aforementioned student. I acknowledge my acceptance of this Assumption of Risk by agreeing to and allowing my child to participate in such classes. MEDICAL EMERGENCIES I hereby authorize the employees of Creative Groove Studio, an identified additional parent/guardian on the registration form, or the identified Emergency Contact to act as my agent and to consent to medical, surgical, or dental examination and/or treatment that may be necessary. I hereby authorize Creative Groove Studio's employees to perform any acts which may be necessary or property to provide emergency health care of my child in the event that the parent/guardian and/or Emergency Contact cannot be reached, including consent to and authorization of medical procedures by qualified, licensed physicians, dentists, hospital or emergency medical personnel, as they, in the exercise of their profession and in their sole discretion, may deem necessary. I understand that I am responsible for all costs and expenses of such medical treatment.

I have read and accept