Clubhouse Application Form 2023-2024
If you are interested in enrolling your child, you must submit the Complete Enrollment Application and  the Enrollment Deposit $100 to secure a spot in our program or hold a space on our waitlist. If your child is placed on the waitlist, your deposit will be held until a space becomes available. If you withdraw your child from the waitlist before a space becomes available, then your tuition deposit may be refunded, however, you must notify Play Adventures in writing. 
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Email *
CHILDS INFORMATION:
Full Name 
 *
Participants Birth Date *
Does your child have any preschool experience?  *
What stage is your child in potty training? *
Do you give Play Adventures permission to share my first name, email, and cell in the school’s family directory (recommended for playdates & forming community)? 
*
Is there anything you would like to share about your child (interests, special needs, allergies)
 *
PARENT or GUARDIAN INFORMATION
Full Name
 *
Email *
Phone Number *
Address ( street, city, state, zip )   *
Does participant reside at this address? (If not, Please provide address of participant). *
SECOND PARENT OR GAURDIAN INFORMATION
Full Name
 *
Email *
Phone Number *
Address (street, city, state, zip) *
Emergency Contact 1 (add name, relation and phone number) *
Emergency Contact 2 (add name, relation and phone number) *
Check the Participant Program Options *
Required
Person/s authorized to pick up/drop off your child (name and phone number) *
I will read the Parent Handbook *
Required
If you are interested in enrolling your child, you must submit the Complete Enrollment Application and  the Enrollment Deposit $100 to secure a spot in our program or hold a space on our waitlist. If your child is placed on the waitlist, your deposit will be held until a space becomes available. If you withdraw your child from the waitlist before a space becomes available, then your tuition deposit may be refunded, however, you must notify Play Adventures in writing. 
(Please Sign and Date)
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