Klimberz Registration Form "*" indicates required fields Parents Name* First Last Contact Email* Mobile Phone*Childs Name* First Last Childs Age*Please enter a number from 4 to 16.Childs Gender* Male Female Other Returning ParticipantHas your child been part of a kids climb program? Yes No Please ask any questions or provide any additional information that you feel is important regarding your child.Select the days that your child is available to attend a sessionPlace a check next to each day that works. Monday Tuesday Wednesday Thursday Friday HiddenRank your prefered days of the weekArrange the items below from first to lastMondayTuesdayWednesdayThursdayFridayHiddenRank your preferred times of the dayArrange the items below from first to last4pm to 5pm5pm to 6pm6pm to 7pmAvailable Mon - Fri Session TimesPlease select the session time(s) that your child is available to attend a session during the days you selected above. 4:00 PM to 5:00 PM 5:00 PM to 6:00 PM 6:00 PM to 7:00 PM EmailThis field is for validation purposes and should be left unchanged.
