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Play Camp - Membership Agreement 

Unlimited Play Camp Membership

REGISTRATION IS STILL REQUIRED FOR EVERY VISIT.

includes:

1 Free Small Coffee {or tea} per visit
1 Free snack for your little one per visit

*This is a recurring monthly membership plan for $89 per month per child
{Card on file will be charged each month}
{add a sibling for $36}
*We ask that you keep your membership for at least 2 months.
*You are free to cancel anytime after that.  Please give us 7 days notice in writing.  

First Member Name

First Name*

Last Name*
First Member Date of Birth*
I certify that I am 18 years of age or older
First Member Signature*
Second Member Name

First Name*

Last Name*
Second Member Date of Birth*
Third Member Name

First Name*

Last Name*
Third Member Date of Birth*
Fourth Member Name

First Name*

Last Name*
Fourth Member Date of Birth*
Fifth Member Name

First Name*

Last Name*
Fifth Member Date of Birth*
Sixth Member Name

First Name*

Last Name*
Sixth Member Date of Birth*
Seventh Member Name

First Name*

Last Name*
Seventh Member Date of Birth*
Eighth Member Name

First Name*

Last Name*
Eighth Member Date of Birth*
Ninth Member Name

First Name*

Last Name*
Ninth Member Date of Birth*
Tenth Member Name

First Name*

Last Name*
Tenth Member Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Auto Pay
I authorize Ginger Bugs to automatically take payment using the current payment method saved on file for my account. via Square Payment System* *A valid credit card can be saved when purchasing this membership- which will then be used for any upcoming automatic payments.*
Yes
No
Terms & Conditions
I understand that I will need to register for each play camp daily*
Yes
No
I understand that I need to keep the membership for at least 2 months however, can cancel anytime by giving a notice in writing at least 7 days before the next auto payment.*
Yes
No
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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