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Forest Registration Form 2022-2023
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* Indicates required question
Clubhouse Participant Name
*
Your answer
Participants Birth Date
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Your answer
Check the Participant Program Options
*
Forest Program 8:00AM-4:00PM $750
AM Forest Program 8:00AM-12:00PM $450
PM Forest Program 12:00AM- 4:00PM $450
Drop in $40
Extended Care Needed - Please contact Naomi regarding extended care.
Other:
Required
Parents/Guardians Names
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Parents/Guardians Names
Your answer
Email
Your answer
Phone Number
Your answer
Address
*
Your answer
Emergency Contact 1 (add name, relation and phone number)
*
Your answer
Emergency Contact 2 (add name, relation and phone number)
*
Your answer
Person authorized to pick up/drop off your child (name and phone number)
*
Your answer
Does your child have allergies? Please include instructions for handling the allergies!
*
Your answer
Is there anything else you would like us to know about your child? Special needs or interests?
Your answer
See Website for Covid 19 Guidelines
*
Yes, I read, understand, & agree to the Clubhouse guidelines!
Required
By signing this registration form you are agreeing to the "Play Adventures Clubhouse Registration Guidelines". (Please Sign and Date)
*
Your answer
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