Registration Form - Children’s High Holiday Program 5778
Name of Parents
Your answer
Name of Child 1
Your answer
Age of Child 1
Your answer
Birth Date Child 1
Your answer
Name of Child 2
Your answer
Age of Child 2
Your answer
Birth Date - Child 2
Your answer
Name of Child 3
Your answer
Age of Child 3
Your answer
Birth date - Child 3
Your answer
Name of Child 4
Your answer
Birth date - Child 4
Your answer
Please select the session(s) your child/children will attend:
Required
Please indicate your seat number:
Men:
Your answer
Women:
Your answer
Women Upstairs / Balcony:
Your answer
Allergies:
Your answer
Notes:
Your answer
To ensure the safety of your children, please note:
• Children must either be in their designated group or with a parent/caregiver.
• We will provide each child with a nametag to wear the entire time he/she is in childcare.
• The elevators are out of bounds for all children.
• To ensure the safety of those children with allergies, no outside food is permitted.
• Any child that disrupts the group will be returned to the parent/caregiver.
Thank you for your cooperation in ensuring a safe and comfortable environment for all.
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