After school 184 interest form

Where kids of all ages play, move, improve, and have fun!



The undersigned is the Parent and/or Guardian of the minor child whose name is listed above (the “Participant”). The undersigned has signed up for the Participant to participate in an after-school ping pong related class/programs (the “Program”) in the fall Fall at the PingPod location at LES, New York (the “PingPod Location”). By signing below, and in consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:

Hereby assumes all of the risks of the Participant participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of Pingpod Inc., its affiliates, officers, directors and employees (“Pingpod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the Pingpod Parties and (iii) from actions or conduct of other participants in the Program.

Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.

Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.

Agrees that the Participant will follow all rules established by the Pingpod Parties for conduct during the Program and acknowledges that the Pingpod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the Pingpod Parties’ determination

Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by Pingpod. Inc.

The undersigned has the choice of arranging for Participant to travel the distance from PS184 school (the “School Location”) or such other location from which Participant will be traveling to the PingPod Location. Alternatively, a PingPod staff member will be walking from the School Location, after school ends, to the PingPod location, and the undersigned may with advance written notice to PingPod choose to permit the Participant to walk with the staff member, and other children whose Parent/Guardian avail themselves of this option, to the PingPod Location (the “Walking Option”). The undersigned, for his or herself, and on behalf of the Participant acknowledges the risks of the Walking Option and nonetheless agrees to utilize the Walking Option if advance written notice is given to PingPod. Further, the undersigned, on his/her behalf and on behalf of the Participant, waives, releases and discharges the Pingpod Parties and any staff member involved in the Walking Option from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the Pingpod Parties and/or any staff member involved in the Walking Option, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Walking Option. It is the responsibility of the undersigned whose child is using the Walking Option to make sure that the Participant is available on time to exercise the Walking Option, and to notify PingPod in advance of any absence or inability to utilize the Walking Option on any particular day. The PingPod Parties and any staff member involved in the Walking Option shall have no responsibility for any failure of any Participant to be available at the required time, to utilize the Walking Option.

I certify that I have read this document and I fully understand its content. I am aware that this is a release of liability and a contract and I sign it of my own free will.
Clear Signature


The price for our PS 184 classes is $600 for 10 weeks of class with 2 hour lessons, and it includes pick up. The minimum amount of participants in this class is set to 3, and the maximum amount of participants is set to 6.

The class is ongoing weekly until the end of the spring semester. We take breaks on school holidays. Sign up for either 10 or 20 weeks to secure your spot!

For our after school program, so long as you cancel until 1 day after the first class you will get an 80% refund. If you cancel until 1 day after the second class you will get a 70% refund. After that there are no refunds.
Ping Pod
To play at PINGPOD requires PROOF OF VACCINATION as part of the KEY TO NYC

To play at PINGPOD requires PROOF OF VACCINATION as part of the KEY TO NYC