Child's Information

  • $400 paid now and $400 paid on January 1

  • $250 paid now and $250 paid on January 1

  • $175 paid now and $175 paid on January 1

Once registered, I understand that Lupine Lane's lunch plan is nonrefundable.

I agree to pay the once annually lunch fee, or if I selected to pay twice, I agree to pay half of the lunch fee now and half on or around January 1.

I, the Releasor, being of lawful age, in consideration of my child being permitted to participate in activities run and/or operated by the Releasee (Lupine Lane) WAIVE, RELEASE, and DISCHARGE the Releasee, her heirs, executors, administrators, legal representatives and assigns from all liability for or by reason of any damage, loss or injury to person and property, even injury resulting in the death of the child of the Releasor, which has been or may be sustained in consequence of the child of the Releasor's participation in the activity described above, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee. I hereby acknowledge and agree that I have carefully read this Waiver and Release agreement, that I fully understand same, and that I am freely and voluntarily executing same. By clicking “I agree” below this release I will be forever prevented from suing or otherwise claiming against the Releasee for any property loss or personal injury that my child may sustain while participating in or preparing for the above noted activity. I have been given the opportunity to seek independent legal advice prior to signing this Waiver and Release agreement. I understand that my child(ren) would not be permitted to participate in the above noted activity unless I signed this Waiver and Release agreement. I understand that this Waiver and Release agreement is binding on me, my spouse, my heirs, my executors, administrators, personal representatives and assigns. I acknowledge that my child(ren) does/do not have any physical limitations, medical ailments, physical or mental disabilities that would limit or prevent them from participating in the above mentioned activity, and, if required, will obtain a medical examination and clearance. I hereby grant the rights and permissions of photographs taken at Lupine Lane events and classes to Lupine Lane, LLC.

$0.00
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