KIDS CLUB ENROLLMENT FORM 

Please provide information which will assist us to provide proper care of your children when in Kids Club.  
Thank you!
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Child's Full Name -1st child *
1st Child's Age: *
1st Child's Birthdate *
MM
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DD
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YYYY
Child's Full Name -2nd child
2nd Child's Age
2nd Child's Birthdate
MM
/
DD
/
YYYY
Child's Full Name - 3rd child
3rd Child's Age
3rd Child's Birthdate
MM
/
DD
/
YYYY
Your Full Name (Parent or Guardian) *
Your Email *
Your Cell Phone Number *
Medical concerns and/or allergy information (please include name): *
I understand that my child and I need to be members of the WRAC to attend Kids Club or there will be a non member fee for all kids club services.  *
Special needs or instruction I have for Kids Club Care Providers: (example potty training or nursing)
Please list people who you authorize to pick up your child from the WRAC facility. *
 Kids Club Policy click here *
I, [Your Name] the natural parent/legal guardian of [Your Child's Name], authorize and consent to medical, surgical and hospital care, treatment, and procedures to be performed for my child by a licensed physician, emergency medical technician, or hospital when deemed immediately necessary or advisable by the physician to safeguard my child's health and I cannot be contacted. I waive my right of informed consent to such treatment and authorize permission to transport my child for emergency purposes in any vehicle driven or accompanied by Wenatchee Racquet & Athletic Club staff for such purpose while in his/her care. *
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