Registration -

TUMBLEBUS Online Registration Form

Child's First And Last Name *

First

Last

Second Child's First and Last Name

First

Last

Child's School *

Birthday

Age

Does your child have any allergies or medical conditions? *

Parent's First And Last Name *

First

Last

Parent's Email *

Contact Information *

Cell or Home

Street Address, City *

First

Last

Example: 1 Tumbling Lane, Monroe

State, Zip Code *

First

Last

Example: NY, 10950

Plan Options *

|| Plan A - $12 Weekly (2nd child $8) Cash or check only || Plan B - Monthly Discount $48 (2nd child half price) || Plan C - Monthly Discount Auto Charge $44 (2nd child Half price) || Plan D - Pay in full (2nd child half price) - Contact office

If Selecting Plan A, Please Select An Option Below

TumbleBus NY will be taking your child EVERY week, unless you call our office to discontinue.

Card Type *

Name (as it appears on card) *

Credit Card Number *

Security Code *

Expiration Date *

Checkboxes *

By clicking this box, you agree to pay the full amount for your plan. Please note that we do not offer refunds for missed classes. In the event that your child misses a class, make-up sessions may be offered subject to availability.

Registration

TUMBLEBUS Online Registration Form

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