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Fit by Nature- New Participant Registration
We are so excited to have your child join the Fit by Nature family! Please complete the form below and contact Mary Cole at (475) 251-6754 with any questions. Thank you!
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Email
*
Your email
What session(s) are you registering for?
Homeschool Program - please contact Mary before registering for dates and locations
Summer Camp- Wallingford- June 17-21 from 10am-2pm $315
Summer Camp- Woodbridge- July 8-12 from 10am-2pm $315
Summer Camp- Wallingford- July 15-19 from 10am-2pm $315
Summer Camp- Wallingford- July 22-26 from 10am-2pm $315
Summer Camp- Wallingford- August 19-23 from 10am-2pm $315
LAST HOORAH DAYS Summer Camp- Wallingford- August 26-28 from 10am-2pm
*A $100 deposit is required when registering for Summer Camp.
Payment can be made by cash, check, or via Venmo @Mary-Cole-116. Thank you!
Child's First Name
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Your answer
Child's Last Name
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Your answer
Nickname / Name your child prefers to be called
Your answer
Date of Birth
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MM
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DD
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YYYY
Allergies / Medical Conditions
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Your answer
Child's Current School
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Your answer
Home Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
Contact Information: Parent/Guardian
Parent/Guadian Name(s):
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Your answer
Phone Number:
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Your answer
Additional Phone Number (if applicable)
Your answer
Email
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Your answer
Additional Email (if applicable)
Your answer
Emergency Contact (other than Parent)
Please list two emergency contacts in the event parents/guardians cannot be reached.
Emergency Contact #1 Name
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Your answer
Relationship to Child
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Your answer
Emergency Contact #1 phone number
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Your answer
Emergency Contact #2 Name
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Your answer
Relationship to Child
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Your answer
Emergency Contact #2 phone number
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Your answer
Additional information: is there anything else about your child that you would like me to know?
Your answer
How did you hear about Fit by Nature?
Your answer
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