2020-2021 FitBrainiacs Evenings & Weekends

Please select your child's school

LOCATIONS

FitBrainiacs West - Wednesdays, 6:00-7:15p

Location Information

Location Name
FitBrainiacs West - Gardens Park (Summerlin)
Address
10401 Garden Park Dr, Las Vegas, NV, 89135 US
Directions
Google, Bing, MapQuest

FitBrainiacs East - Saturdays, 10:30-11:45a

Location Information

Location Name
FitBrainaics East - Sunset Park, Pavilion F
Address
7000-7030 S Eastern Ave, Las Vegas, NV, 89120 US
Directions
Google, Bing, MapQuest

REGISTRATION

Step One:

Please select the location(s) where your child will attend.

Choose:

FitBrainiacs West - Wednesdays - 6:00-7:15p
FitBrainiacs will meet at Gardens Park (Summerlin)
FitBrainiacs East - Saturdays - 10:30-11:45a
FitBrainiacs will meet at Sunset Park, Pavilion F

Step Two:

Please select the in-person sessions you would like your child to attend. You may select multiple dates or registration options. Note: You must first select at least one location above before all registration options will be shown.

FitBrainiacs West
Wednesdays, 6:00-7:15p

$15 per session

Please select this location option above to see registration options.

FitBrainiacs East
Saturdays, 10:30-11:45a

$15 per session

Please select this location option above to see registration options.

Long Term

$13 per session

Please select at least one location option above to see registration options.

VOLUNTEERING INFORMATION

Volunteers are choosing to exchange their time for their child's free enrollment. Volunteers will assist our trained coaches with coordinating the class and ensuring everything runs smoothly. No training is required prior to participation. Anything you need to know to assist will be explained during each class session.

Please note the following conditions:

You will receive free enrollment for one child for each session at which you volunteer to assist.
You will need to register and pay prior to your child's participation and you will receive a refund or credit at the end of each semester.
We require at least 24 hour notice that you will not be able to participate in a scheduled session. We understand that things come up, but please let us know as soon as possible if you will be unable to attend.
Failure to fulfill all requirements of our Volunteer Agreement may result in your removal from future volunteer opportunities.

I am interested in volunteering to help with class in exchange for my child's free enrollment.

You may choose individual sessions or weeks for which you are available. Contact us for more information.

PARENT INFORMATION

Parent/Guardian's Name:

Email:

Phone Number:

Preferred Contact Method:

Email
Text
Phone

Address:

CHILD INFORMATION

Child's Name:

Child's Date of Birth:

Child's Gender:

Male
Female

Who is your child's teacher?

How will your child(ren) be getting home after class?

Other:

Does your child have any medical/behavioral issues that may impact their ability to succeed in FitBrainiacs?

EMERGENCY INFORMATION

Emergency Contact (If parent/guardian cannot be reached):

Emergency Contact Phone Number:

Relationship to child:

Health Insurance Provider:

Insurance Policy Number:

Hospital Preference:

Child's Doctor:

Doctor's Phone Number

Photo Consent*

By registering, I am giving my permission for my child/children to be photographed during FitBrainiacs classes and events. I understand that these photographs may be used in marketing materials through print, video, and online channels. Please contact us with any questions.

Terms, Conditions, and Waivers

I, the undersigned, agree to the terms above.

E-Signature Disclosure*

By signing this document, you give your consent to electronic disclosures and to the use of electronic signatures. This CONSENT informs you of your rights when receiving legally required disclosures, notices and information from us and when using electronic signatures in connection with your transactions with us. By consenting to the electronic delivery of disclosures, you agree that we may provide electronically any and all communications to you. You are not required to receive notices and disclosures or sign documents electronically. If you prefer not to do so, you may request to receive paper copies and withdraw your consent at any time.

FITBRAINIACS MERCHANDISE

Each child will receive a FREE FitBrainiacs water bottle and sport towel with their first enrollment of 4+ sessions. These items are available for purchase below for students registered for individual days/weeks or if you need a replacement.

FitBrainiacs Water Bottle
$5.00 ea.
Add
FitBrainiacs Cooling Towel
$5.00 ea.
Add

Subtotal

$0.00

DISCOUNTS

We are happy to offer a one time $10 discount to these valuable members of our community. Please click the checkbox if you qualify and your registration total will be adjusted automatically. Thank you!

We qualify for the Educator (Teachers/Administrators/Support Staff) discount.
We qualify for the First Responder (Police/Fire/EMT) discount.
We qualify for the Military (Active Duty/Veteran Servicemembers) discount.

Please note: educator, first responder, and military discounts may not be combined and may not be used on top of early bird pricing.

If you qualify for this discount and have trouble applying it with the checkboxes above, please manually enter the code DISCOUNT12.

Educator, First Responder, Military Discount

Additional Coupon Code

Credit Card Processing Fee

$0.00

Note: Processing fee may be avoided with offline check/cash payment. Please select the Offline option during billing and contact us directly to make payment arrangements.

Total

$0.00

Billing Disclaimer*

I understand that FitBrainiacs reserves the right to bill the credit card kept on file for any sessions attended beyond those that have been paid. We will send periodic updates to let you know how many sessions your child has remaining and you may contact us at any time for this information.

Refund Policy*

I understand and accept FitBrainiacs' refund policy:

If you are not completely satisfied after your child attends their first class session, please let us know and you will receive a full refund for any unused sessions*. No refunds will be issued after a child has attended a second time.

*Processing fees may apply.

Almost done, where should we send the confirmation?

Name

Phone Number

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