Paleo Play / AfterSchool Program Registration / Spring 2021
* Required
Email
*
Your email
Child's First Name:
*
Your answer
Child's Last Name:
*
Your answer
Child's Age:
Your answer
Which program are you registering for?
*
GROUP 1(CRPS), 1-4.30pm on designated Fridays, [ April 23, May 7, 21, June 4, 11 ]
GROUP 2 (OLS) : 1-4.30pm on designated Fridays, [ April 16, 30, May 14, 28, June 18, 25]
Parents/Legal Guardian Name(s):
*
Your answer
Phone Number (daytime):
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Your answer
Alternative/Emergency Phone Number:
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Your answer
Street Address:
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Your answer
City/Town:
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Your answer
Postal Code:
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Your answer
Does your child have any allergies/medical conditions?
*
Choose
Yes
No
If yes, please specify
Your answer
Will you permit photos and/or video to be taken of your child and displayed and/or used for promotions by Paleo Play?
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We will not publish childrens' names with any images.
Choose
Yes
No
Please make sure to fill out your Medical + Waiver forms (which you will receive via email)
*
Indicate below how you will be returning your forms.
Choose
Sending via Email to paleoplaycanmore@gmail.com
Sending via CanadaPost to 8 West Park Place, Cochrane, AB T4C 1J7
Please indicate your method of payment.
*
FEES: GROUP 1 : [5 sessions x $35/day = $175 ] GROUP 2 : [6sessions x $35/day = $210]
Email Transfer (send email to
paleoplaycanmore@gmail.com/
PASSWORD : paleoplay)
Cheque (Payable to Corey Stevens, 8 West Park Place, Cochrane, AB T4C 1J7 )
Required
A copy of your responses will be emailed to the address you provided.
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