KIAGA MEMBERSHIP / CLASS REGISTRATION FORMLast Name_________________________________________________ Mother’s/Father’s Name_____________________________Address____________________________________________________________ City/Zip___________________________________Home Phone_______________________ Cell Phone_______________________ Email_____________________________________

_______________________________________________________________________________________________________ Highest Fee ____________________________________________________________________________________________________________10% off______________________________________________________________________________________________________________10% off______________________________________________________________________________________________________________10% off_______

o Please automatically re-enroll my child during priority registration Total Class Session Fee $_____________and charge my credit card until I notify KIAGA otherwise. Automaticre-enrollment does not apply to Summer sessions.

Annual KIAGA Registration Fee: First Child $30 $_____________(Prorated throughout calendar year) Second Child $25 $_____________

Third Child $10 $_____________

TOTAL AMOUNT DUE $_____________

Cash___ Check___ Visa/MC#____________________________ Exp.______ Signature____________________________

Parental ReleaseI hereby give my consent for my child to participate in gymnastics classes at Kids In Action Gymnastics Academy. I am fully aware that gymnastics presents

a risk of injury during training. I am fully aware of and appreciate the risk and damages that might occur as a result of my child’s participation in or attendanceat gymnastics class.

In consideration of your accepting my registration, I hereby, for myself, my child(ren), my heirs, executors and administrators, waive and release any and all rights or claims for any damages I or my child(ren) may have against Kids In Action Gymnastics Academy and any of its representatives, successors or agents for any and all injuries sustained or suffered by myself or my child(ren) at any activity sponsored by these groups. I do hereby verify that I fully understand and accept the preceding conditions for permitting my child to participate in any KIAGA events, classes, practices, or special sessions.

Parent Signature_______________________________________________________ Date__________________________

PARENTS’ NIGHT OUT/SATURDAYSSeptember 13, October 18, November 8, December 13January 10, February 21, March 14, April 11, May 9

6:00 to 10:00 pmParents drop the kids with us for open gym time, tumbling,

games, movies, snacks, and just plain fun!Kids must be at least 3 years old.

BIRTHDAY PARTIESParty times available on Saturdays and Sundays:

12:30 to 2:00 p.m. • 1:30 to 3:00 p.m.2:30 to 4:00 p.m. • 3:30 to 5:00 p.m.

Call for more information!Day off of school? There are weekday parties available!

(Upon request)

Cost:1-10 Kids • $17011-20 Kids • $20021-30 Kids • $230

SPECIAL SESSIONS

Child's Name Class Day Time Birthday Sex Fee

OPEN GYMTots to 10 yrs.: Fridays from 7:00 to 8:30 PMAges 11 and up: Fridays from 8:30 to 10:00 PM

$8.00 for current KIAGA registrants $10.00 for non-registrants

Open Gym for all Ages Current Non-Registrants Registrants

Mon 2:00 PM to 3:30 PM $ 5. 00 $ 6.00Tues 3:30 PM to 4:00 PM $ 2.00 $ 4.00Wed 10:30 AM to 11:30 AM $ 4.00 $ 5.00Wed 2:00 PM to 3:00 PM $ 4.00 $ 5.00Thurs 2:00 PM to 3:00 PM $ 4.00 $ 5.00Thurs 3:30 PM to 4:00 PM $ 2.00 $ 4.00Fridays See above for times and fees.Sun 5:30 PM to 7:00 PM

Summer Open Gym: All AgesSummer Open Gym Schedule - Starts June 8, ends August 22

Mon 2:00 to 3:00 PM $ 4.00 $ 5.00Wed 2:00 to 3:00 PM $ 4.00 $ 5.00Fri 6:30 to 8:00 PM $ 8.00 $10.00

NO CLASSES:September 1

November 27, 28December 24, 25January 1, 2015May 25, 2015

ACADEMIC & ATHLETIC PRESCHOOLYour typical Preschool in a non-typical space!

Fall - 20142-Day, 3-Day, or 5-Day Options - Morning

09:00-11:30 am09:50-10:30 am09:50-10:30 am10:40-11:20 am

12:20-01:00 pm01:10-01:50 pm06:00-06:40 pm06:45-07:25 pm09:50-10:30 am10:40-11:20 am

12:20-01:00 pm01:10-01:50 pm06:00-06:40 pm06:45-07:25 pm04:15-05:05 pm05:10-06:00 pm06:00-06:50 pm04:15-05:05 pm05:10-06:00 pm06:00-06:50 pm04:15-05:05 pm05:10-06:00 pm06:00-07:20 pm

04:15-05:05 pm05:10-06:00 pm06:00-08:00 pm 04:00-06:00 pmJ.J./Must Try Out

$210

09:00-11:30 am

09:50-10:30 am10:40-11:20 am

12:20-01:00 pm01:10-01:50 pm04:15-04:55 pm05:10-05:50 pm09:50-10:30 am10:40-11:20 am

12:20-01:00 pm01:10-01:50 pm04:15-04:55 pm05:10-05:50 pm04:15-05:05 pm05:10-06:00 pm06:00-06:50 pm04:15-05:05 pm05:10-06:00 pm06:00-06:50 pm04:15-05:05 pm05:10-06:00 pm06:00-07:20 pm

04:15-05:05 pm05:10-06:00 pm

Team04:15-05:05 pm05:10-06:00 pm

09:00-11:30 am09:50-10:30 am09:50-10:30 am10:40-11:20 am11:30-12:10 pm12:20-01:00 pm01:10-01:50 pm04:00-04:40 pm05:00-05:40 pm09:50-10:30 am10:40-11:20 am11:30-12:10 pm12:20-01:00 pm01:10-01:50 pm04:00-04:40 pm05:00-05:40 pm04:00-04:50 pm05:00-05:50 pm06:00-06:50 pm04:00-04:50 pm05:00-05:50 pm06:00-06:50 pm04:00-04:50 pm05:00-05:50 pm 06:00-07:20 pm

04:00-04:50 pm05:00-05:50 pm06:00-08:00 pm 04:00-04:50 pm05:00-05:50 pm

09:00-11:30 am

09:50-10:30 am10:40-11:20 am11:30-12:10 pm12:20-01:00 pm01:10-01:50 pm

09:50-10:30 am10:40-11:20 am11:30-12:10 pm12:20-01:00 pm01:10-01:50 pm

04:15-05:05 pm05:10-06:00 pm06:00-06:50 pm04:15-05:05 pm05:10-06:00 pm06:00-06:50 pm 04:15-05:05 pm05:10-06:00 pm 06:00-07:20 pm

04:15-05:05 pm05:10-06:00 pm

Team04:15-05:05 pm05:10-06:00 pm

09:00-11:30 am09:50-10:30 am 09:50-10:30 am10:40-11:20 am11:30-12:10 pm

09:50-10:30 am10:40-11:20 am11:30-12:10 pm

05:00-05:50 pm06:00-06:50 pm

(Saturday $210)

05:00-05:50 pm06:00-06:50 pm

08:30-09:10 am08:30-09:10 am09:20-10:00 am10:10-10:50 am11:00-11:40 am

08:30-09:10 am09:20-10:00 am10:10-10:50 am11:00-11:40 am

09:20-10:10 am10:10-11:00 am11:00-11:50 am 09:20-10:10 am10:10-11:00 am11:00-11:50 am 09:20-10:10 am10:10-11:00 am 09:00-11:00 am

11:00-11:50 am

09:20-10:10 am10:10-11:00 am11:00-11:50 am

KIAGA Year - Round SCHEDULEMon Tue Wed Thu Fri Sat

SUMMER CAMP $27.50/day, $22.50 siblingsPARENT TOT (18 mos-3 yrs) *FEE $140PRE-SCHOOL(3-4 years) *FEE $140Sign up for two classes between9:50 and 1:10 and receive 50% OFFyour second class!(Same child Monday - Saturday)

KINDER-GYM(5-6 years) *FEE $140Sign up for two classes between9:50 and 1:10 and receive 50% OFFyour second class!(Same child Monday - Saturday)

GIRLS BEGINNER - LEVEL 1(6-16 years) *FEE $140

GIRLS ADV. BEGINNER - LEVEL 2(6-16 years) *FEE $140

GIRLS INTERMEDIATE - LEVEL 3(6-16 years) *FEE $140GIRLS ACCEL’D INTERMEDIATE *FEE $180POWER TUMBLING / TUMBLINGTRAMPOLINE & TUMBLING *FEE $140Boys and Girls All Ages (6-16)ACCELERATED TRAMP *FEE $210BOYS BEGINNER TO INTERMEDIATE(6-16 years) *FEE $140

CLASS

Power Tumbling *FEE $140Must Have Round Off Flip Flop

Minimum

Monday: 6:00pm - 6:50pmMonday: 7:00pm - 7:50 pmFriday: 6:00pm - 6:50pm

Tumbling *FEE $140

Mon-Thurs: 6:00pm - 6:50pmWednesday: 3:15pm - 4:05 pmWednesday: 5:00pm - 5:50pmThursday: 4:15pm - 5:05 pmThursday: 5:10pm - 6:00pm

HAVE A SCHOOL FUNDRAISER ATKIDS IN ACTION!

Call Office for details. Dates already booked:Roslyn Road School - Nov. 22, Jan 24, 5:30-7:00 pm

Relay for Life Event - Apr. 17, 5:30-7:30 pm

Check out the Kids In ActionAcademic & Athletic Preschool Program!

Did You Know You May Register Online? Visit: www.kiaga.com

Trampolines!

Join a NEW Friday Bo

ys

or Girls Beginner an

d

receive an Open Gym

pass EVERY Friday!

HOME SCHOOL (School Year) Tuesday 2:00-2:50 pm (Preschool & School Age Class) Thursday 2:45-3:30 pm (Preschool & School Age Class)

SEE  BOXES  BELOW  FOR  CLASS  DAYS  AND  TIMES

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