You are registering for the Family Nature Play Class summer session (choose 1-2 options): *
Required
Child Information
How many children will be with you? *
Your answer
First Names *
Your answer
Age range *
Your answer
Parent / Guardian informations
First Name *
Your answer
Last Name *
Your answer
Child's relationship *
Your answer
Address *
Your answer
Phone number *
Your answer
Photo release waiver
Do you authorize us to share pictures or videos of your child on social media (Facebook /Instagram) and/or prints to promote our program? *
Barnacles and Bees is an all outdoor, rain or shine program. The forest/park is our classroom and there may be no indoor facilities. Caregivers are responsible for their child at all time and must remain on site during the event. *
Date *
MM
/
DD
/
YYYY
Signature *
Your answer
A copy of your responses will be emailed to the address you provided.