Register for Klimberz Program

Advance registration is required! Please complete the form below and we will contact you to place your child in the appropriate group.

Space is limited.
All students must have a properly completed digital waiver on file. This must be completed by the child’s own parent.
All students must have a properly completed entrance survey on file. This must be completed by the child’s own parent.

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
Returning Participant
Has 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.
Rank your prefered days of the week
Arrange the items below from first to last
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Rank your preferred times of the day
Arrange the items below from first to last
- 3pm to 4pm
- 4pm to 5pm
- 5pm to 6pm