Registration: Songbirds, a Wild Roots Parent-Child class
SONGBIRDS
For parents and toddler-aged children (sturdy walkers up to 2.5 years)

​5 meetings per session, 9:00am-11:00am

Fall Session:
Five consecutive Mondays all in the month of October.
October 1, 8, 15, 22 & 29
Location: Rocky Nook Park

Winter Session: THIS SESSION IS FULL! Registration closed.
Five Mondays
January 7, 14, 28 and February 4 & 11
* Note: MLK Jr. Day on January 21st is a holiday so we will not meet that Monday.
Location: Lake Los Carneros

Early Spring Session: REGISTRATION OPEN!
This session begins on a Friday due to Presidents Day weekend, followed by four consecutive Monday’s.
Friday, February 22
Monday, February 25
Monday’s, March 4, 11 & 18
Location: Lake Los Carneros

Cost: $150 per session

Payment information:

Payment is due to secure your space, and can be made through:
1) Google Pay to wildroots.sb@gmail.com
2) Check made out to "Wild Roots" and mailed to 3730 Avon Lane, Santa Barbara, CA 93105
**Please include a memo: Songbirds, Parent Name, Session Date**

Cancellation Policy and Session Change Policy:

Up to 4 weeks prior to a session start date: For a cancellation, your payment is refundable, less a $30 cancellation fee. No charge to change to a future session within 9 months.

From 4 weeks up to 2 weeks prior to a session start date: For a cancellation, if we can fill your space from the waiting list, your payment will be partially refunded, less a $30 cancellation fee. If we are not able to fill your space, payment is non-refundable, yet is fully transferable to a future class within the 9 months. No charge to change to a future session within 9 months.

After 2 weeks prior to a session start date: Payment is fully non-refundable, and is partially transferrable (50% of the fee may be credited to a future class within 9 months).

*If a Songbirds class is cancelled by Wild Roots, all payments made will be fully refunded.*

Contact:
You are welcome to contact Juniper with questions at juniperdwight@gmail.com.

Child's Name *
Your answer
Child's Birthdate *
Your answer
Child's Gender *
Parent / Guardian #1 Name *
Your answer
Parent / Guardian Best Daytime Phone Number *
Your answer
Parent / Guardian #1 Email Address *
Your answer
Parent / Guardian #2 Name
Your answer
Parent / Guardian #2 Best Daytime Phone Number
Your answer
Parent / Guardian #2 Email. Address
Your answer
Choose a session
Fall session, starts Oct 1
Winter session, starts Jan 7 - SESSION FULL
Early Spring session, starts Feb 22 *
Required
EMERGENCY CONTACT INFORMATION. Please provide 2 emergency contacts. (Full Name, Relationship to you, Phone Numbers w/area codes, if cell phone or land line) *
Your answer
CHILD: Please list any allergies your child has (Foods, Environmental, Medications, Insects) as well as frequency, duration and treatments *
Your answer
PARENT: Please list any allergies the parent/s attending the program has (Foods, Environmental, Medications, Insects) as well as frequency, duration and treatments *
Your answer
Please tell us who lives in the house with you? Adults? Siblings? Friends? Other children, etc?
Your answer
How many hours of visual media (TV, computer,videos) does your child experiences? Please include whether number is a daily or weekly basis, and what types of media.
Your answer
Do you have any concerns you would like to share with us?
Your answer
Terms
Cancellation Policy and Session Change Policy:

Up to 4 weeks prior to a session start date: For a cancellation, your payment is refundable, less a $30 cancellation fee. No charge to change to a future session within 9 months.

From 4 weeks up to 2 weeks prior to a session start date: For a cancellation, if we can fill your space from the waiting list, your payment will be partially refunded, less a $30 cancellation fee. If we are not able to fill your space, payment is non-refundable, yet is fully transferable to a future class within the 9 months. No charge to change to a future session within 9 months.

After 2 weeks prior to a session start date: Payment is fully non-refundable, and is partially transferrable (50% of the fee may be credited to a future class within 9 months).

*If a Songbirds class is cancelled by Wild Roots, all payments made will be fully refunded.*

I have read and understand the above terms and agree to abide by these and all other Wild Roots Policies. (Sign name below) *
Your answer
Payment Info
Cost: $150 per session

Payment is due to secure your space, and can be made through:

1) Google Pay to wildroots.sb@gmail.com
2) Check made out to "Wild Roots" and mailed to 3730 Avon Lane, Santa Barbara, CA 93105

**Please include a memo: Songbirds, Parent Name, Session (Fall, Winter, or Early Spring)**

Please indicate your payment method. Space is not secure until payment is received. *
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