Baby and Me Registration Form

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Baby and Me Registration Form - 10:00 AM

We welcome you to our Baby and Me Developmental Skills Play Group every Monday!

You are registering for our 10:00 AM group on May 20th

The group is FREE for the remainder of the school year.

We kindly ask the children to be between the ages of 6 months to 4 years.

We look forward to seeing you!

Email *

Parents Name *

Child's Name *

Age of Child *

I understand EACH child/sibling must be registered individually to ensure a spot is guaranteed. *

I understand

I am registering for May 20th at 10 AM *

Correct

Phone Number *

I understand I am to stay with my child(ren) during all activities, and be respectful to the property and other children on the premise. *

I understand

I understand and I give for my child(ren) to be included in photos or videos that may be featured on the ELEVATE HEALTH (Formerly Speech Language Associates) website, and/or social media pages.

I understand that my child's name will not be linked to the posted pictures or video.

Yes

No, thank you

I understand that if my child is sick, my child will not be able to participate. ELEVATE HEALTH (Formerly Speech Language Associates) is not liable to any child's sickness, but will do its best to maintain cleaning procedures.
*

I understand

What are you hoping to learn from this playgroup?

Send me a copy of my responses.

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