Spring Break Program Registration
Welcome to One Fire Forest School at Ecovillage Ithaca!   Please complete one registration form for each participant.  Once your registration form is received, we will contact you directly to confirm that space is available, share additional information, and make payment arrangements. Thank you for your interest in the positive youth development programs at One Fire Forest School! 
Unless otherwise noted, the ICSD School Break Day format is:  9am-3pm "Forest Friends" group for 5-8 year olds and older (kids only) is $50 per participant per day.  From 9-11am, 5 and under "Forest Kids" are welcome to join us with a caregiver (donation based -- suggested $20-25 per program day).  Family rates and sliding scale are available -- please contact Wren directly by texting 314-322-3480.
Sign in to Google to save your progress. Learn more
Spring Break schedule:  Please use check boxes to register. 
Participant's First and Last Name
Participant's birthdate and age (i.e. 3/16/2014, age 7)
Participant's gender identity (check any/all that apply)
Health history of note:  Please share anything that we should be aware of, particularly any significant allergies.  
Permissions (please check all boxes that apply)
Parent/Caregiver Contact information: First and Last Name
Parent/Caregiver Contact information: Preferred email address
Parent/Caregiver Contact Information: Primary phone number
Parent/Caregiver Contact Information: Secondary phone number (optional)
Second Contact Person: First and Last Name, please include relationship to participant
Second Contact Person: Primary and secondary phone numbers
Please indicate the total amount due for your program choices:
Forest Friends (5 and older -- kids only) is $50 per participant per day.  
Forest Kids (5 and under with caregiver) is donation based -- suggested $20-25)
Family rates and sliding scale available -- please contact Wren at 314-322-3480.
Please indicate your intended payment method:
Clear selection
Preferred payment option
Clear selection
A $50 deposit is requested at the time of registration.  Please make arrangements to pay the deposit at the time you submit this form.  
Your deposit will be fully refunded if the program is cancelled by One Fire.  If you decide to cancel your registration, your deposit is 50% refundable up to 5 days prior to the start of the program, and non-refundable within 5 days of the start of the program.  
A signed and dated Release Form is required prior to participation in all One Fire Nature School programs.  
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy