Warrior Kids
Registration for after school program April 13- May 18   2:50-4pm each Wednesday for 4th & 5th grade students
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Email *
Child's Name *
Parent/Guardian  Name *
Parent/Guardian Email *
Parent/Guardian Phone # *
Food Allergies *
I am able to pick up my child promptly at 4pm every Wednesday and understand that if I am more than 10 minutes late on 2 different occasions, my child will longer be able to participate in the program?           (please answer yes and who is allowed to pick up child) *
I understand and acknowledge that the individuals participation is completely voluntary and I do not hold Wa-Nee school or Warrior Kids liable.                                                                                    (By typing your name below, you are signing in agreement with the above statement.).   *
Photo Release, I herby grant Warrior Kids permission to use photos or videos for promotional materials associated with Ignite Infinity.
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Emergency Contact  Name/ # *
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