Register for Weekend Playgroup Parent/Guardian Name * First Name Last Name Email * Phone * (###) ### #### Child's Name * First Name Last Name Child's Date of Birth MM DD YYYY Preferred Session/Date * Check all that apply 4 Saturdays, April 5th - April 26th ($110 total) 5 Saturdays, May 3rd - May 31st ($140 total) Drop-In (Call for availability) $30 per session Timeslot * 9:00am - 11:00am (1-3 Year Olds) 12:00pm - 2:00pm (4-6 Year Olds) Confirmation & Agreement * By submitting this registration form, I agree to the following terms and conditions: Health Physical Form and Immunization Records: A completed and recent health physical form and updated shot records are required prior to my child's participation in the weekend playgroup. A physical form will be provided to you upon registration and must be submitted before your child begins the program. Payment: Full payment for the playgroup option selected is due prior to starting and will be billed accordingly. Further details regarding payment will be provided upon registration. Communication: I understand that a member from the team will contact me soon to confirm my registration and provide additional information. By clicking "Submit," I acknowledge that I have read, understand, and agree to the terms listed above. I Agree Thank you!
