Child's Name*

Child's Classroom*

Child's age*

Parent's name*

Parent's email*

Address

Phone

School / Organization

Kids in Motion Class

Your child will remain under the care, direction and supervision of the school while receiving instruction in the Kids in Motion programs. I hereby release and discharge, Kids in Motion, the childcare facility, and its members from all actions, claims, demands, injury or damage resulting from my child’s participation in this activity. There are NO refunds for missed classes.
I agree with the Liability Release
I give Kids in Motion permission to publish pictures and/or videos of my child participating in the Kids in Motion programs.
I agree with the Photo ReleaseI don't want my child photographed

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To finalize registration, choose your payment method:

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Pay online

We accept VISA, MasterCard and Discover. To pay online please click here.

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Pay with a check

Mail check payable to:

Kids in Motion
239 New Road, Building B 315
Parsippany, NJ 07094

No payment due

If your school or club has made payment arrangements directly with Kids in Motion then no payment is due.