Playful Nature Explorers 2024-2025 Registration Form
Please fill out this form for each child you wish to register for Playful Nature Explorers. ICG staff will get back to you once you complete the form to let you know if space is available or to see if you are interested in being on a waitlist. Note that we prioritize full, 4-day schedules.
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Email *
Child Name (first and last) *
Parent/Caretaker 1 Name (first and last) *
Confirm Parent/Caretaker 1 Email Address *
Parent/Caretaker 1 Phone Number *
Parent/Caretaker 2 Name
Parent/Caretaker 2 Email Address
Parent/Caretaker 2 Phone Number
Street Address *
City *
Zip Code *
Child Birth Date *
MM
/
DD
/
YYYY
Is your child potty trained? Please see our FAQ for more information if you are unsure. *
How many days per week are you interested in enrolling? Please note that we prioritize 4-day schedules. *
Which days of the week are you interested in enrolling? *
Required
If you have any other information about the days you wish to register, please share them here. This may include preferring a 3 day schedule, but okay with a 4-day or needing a late start or early end to the year.
What are your child's pronouns?
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Please tell us a little about your child.
Are there any special concerns that we should be aware of? Allergies? Dietary restrictions?
Please tell us about any accommodations that will help your child thrive at Playful Nature Explorers
Do you give permission for your child’s photo to be taken during the activity and for any photo to be used for documentation and publicity purposes?
 *
Emergency Contact (Name and Phone Number)- This should be someone OTHER than the parent/guardian(s) listed above. *
Please list the names and phone numbers of all of the people approved to pick up your child from the program.

If the cost of the program poses a barrier to participation, please consider filling out our scholarship form.

Would you like to fill out the need-based scholarship form?

 *
Do you have any questions for us?
How did you hear about Playful Nature Explorers?
Demographic Questions
These demographic questions are entirely optional and help ICG understand our audience and work to improve our reach.
What is your child's race and ethnicity? (select all that apply)
Which of the following best describes your child's gender? (select all that apply)
What languages does your child speak?
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