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Parent Registration & Waiver

Thank you for enrolling your child in the Balance Bike Program.

This program is designed to build confidence, coordination, balance, and listening skills in a safe and structured environment. Our goal is to help children feel strong in their bodies while developing skills that directly support classroom readiness and everyday movement.

Please complete the form below to secure your child’s spot.

Child Information

Child FIrst Name

Child Last Name

Age

School Name

Classroom / Teacher Name

T-Shirt Size

Child Size

Parent / Guardian Information

Parent First Name

Parent Last Name

Relationship to Child

Primary Email Address

Mobile Phone Number

Emergency Contact

Emergency Contact Name

Relationship

Phone Number

Medical & Safety Information

To ensure a safe experience for all children, please share any relevant information below.

Does your child have any medical conditions we should be aware of?

Any physical limitations?

Does your child wear glasses?

Any sensory sensitivities we should be aware of?

Has your child used a balance bike before?

Has your child ridden a pedal bike with training wheels?

Comfort Level on a Bike

Photo/Video Permission

Liability Waiver & Assumption of Risk

Participation in the Balance Bike Program involves physical activity, including riding balance bikes and engaging in structured movement exercises. While safety procedures and supervision are in place, minor falls and physical risks are inherent to this type of activity.

By registering my child, I acknowledge:

• I understand the nature of the activities involved.

• I assume responsibility for any risks associated with participation.

• I release Top Step Development and the hosting school from liability for injury or loss resulting from participation, except in cases of gross negligence.

• My child is physically able to participate in this program.

Communication Consent

I agree to receive email updates about future programs and events from Top Step Development. I understand I may unsubscribe at any time.

Digital Signature

Parent / Guardian Full Name

Signature

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Date

Month

Day

Year