Open Gym/Toddler Play Checkout Parent Name* Child Name* Email Toddler Play or Open Gym?*Toddler PlayOpen GymOpen Gym - Price Per Student Quantity* Price: $10.00 Quantity Please select a quantity Friday 5:30-7PMToddler Play - Price Per Student Quantity* Price: $5.00 Quantity Please select a quantity Friday 10AMHold Harmless Agreement* I Agree By checking this box, I, the undersigned, in consideration of participation in this program, agrees to indemnify, defend, hold harmless and release Miss Maria’s Dance, Cheer & Gymnastics, Inc., its officers, directors, instructors, employees and/or assigns, from any and all direct or indirect liabilities, injuries and/or death, costs, damages and reasonable attorneys’ fees, which may be suffered by the below named individual registered in this program arising out of or in any way connected with participation in the program including parties and special events.Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name