Request for Information and Open House Registration Form
This form provides us basic information so we can help address your needs in faster, more streamlined manner.
Your privacy is important to us.
We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization. Unless you ask us not to, we may contact you via email in the future to tell you about upcoming play group events.
Upon your request we will update or delete any information you provide us, and you may opt out of any future contacts from us at any time by contacting us via the email address given on our website:
Parent Name *
Last name optional
Email address *
Phone number
*Optional. For your convenience only. We primarily communicate via email.
What days are you available to attend?
The maximum number of children we enroll for each day is 20. Due to this, we occasionally have a limited number of openings on one of our playgroup days. The following information will help us sort out what days you are available that still have openings on the roster.
Which Playgroup Day(s) are you Interested in? *
Please check all days that you are available to attend. If you can be flexible on which day you attend let us know. That helps us to make sure you don't end up on a wait-list.
How many children would you like to bring to play group?
How many children under 12 months *
How many children 1 to 5 years old *
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