Virtual Class Registration Package #3

Register for Virtual Classes at SPACE:
3 Classes a Week

SPACE Virtual Class Registration Package #3

12 Classes Monthly (3 class a week)

1. Sign the consent form

2. Register your child

3. Pay the first month

4. Receive your virtual ZOOM link for the class you chose

5. Have Fun!

Step 1: Sign the Consent Form
Please check and sign to acknowledge and agree to the below terms of service:
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- Purchase of package or class(es) is required to receive the months’ “all-access” virtual classes zoom link.
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- By purchasing a SPACE Gym package, I understand that I am paying for a specific class limit associated with the package amount. I must purchase a new package every month as the packages are termed at one month.
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- Gym class packages are pre-paid monthly with no refunds. No cancellation necessary as the all-access package package gives the participant the power to join when available (at your leisure).
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- Participants have the convenience of changing packages at the start of every month to accommodate needs and availability. Class passes do not rollover.
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- I am required to have a credit card on file for payment security. The card will only incur additional charges if my prepaid class limit is exceeded or if I choose to add more classes.
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- I understand that packages are only for one month. My card will not be automatically charged for a new month’s package. I must email, call, or pay online each month.
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- SPACE Gym strongly advises me to monitor the use of my class passes as I am subject to be charged at the regular $30 price per class for each extra class joined that is over the limit of my package number. If I wish to add more classes during my prepaid month, this will be available to me at a $30 price per every additional class.
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- I agree to have fun and enjoy the interactive virtual experience!! 🙂
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- SPACE has the right to refuse service if deemed necessary after given up to 2 warnings for actionable causes.
PRIVACY POLICY
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- SPACE Therapy & Gym virtual gym classes are not medical services. Persons accessing the virtual class(es) will be subject to disclosing their face(s) and name(s) to others that are accessing the same virtual gym class link. SPACE Gym does not disclose private HIPAA information as it does not apply to the gym classes; therefore, HIPAA privacy does not apply.
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- Virtual zoom sessions are subject to being recorded for in house educational purposes only. Recordings will be password protected and only accessed by staff members employed by SPACE Therapy & Gym. Media footage will not be used for any other purposes unless granted permission by guardians.
My Name*
First Last
Name of Child Participating in Classes*
First Last
My Email*
Today's Date*
Date Format: MM slash DD slash YYYY
Virtual Signature*
Enter your name as it appears in your written signature. By inputting your name into this field you are authorizing its use as consent in this binding agreement between myself and SPACE Therapy & Gym, LLC. By signing this form you are acknowledging that you understand and agree to the above checked statements.

Register for Virtual Classes at SPACE:3 Classes a Week

12 Classes Monthly (3 class a week)

Step 1: Sign the Consent Form

Register for Virtual Classes at SPACE:
3 Classes a Week