T-Spoons Tot Spot Enrollment Form
This form must be filled out in entirety before initial drop-off.
Email address *
Parents'/Guardians' Full names *
Your answer
Parents'/Guardians' Cell Phone Numbers *
Your answer
Emergency Contact Name (list someone other than the parent who is authorized to pick up your child in the event of an emergency):
Your answer
Emergency Contact Relationship to Child: *
Your answer
Emergency Contact Phone Number *
Your answer
Children's Names *
Your answer
Children's Age (minimum age 4 months) *
Your answer
Is your child fully capable of using the potty him/herself? *
List any pertinent information about your child (allergies, preferences, special needs, etc.) :
Your answer
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