Paleo Play / AfterSchool Program Registration Fall 2019
* Required
Email address
*
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?
*
SESSION 1 CRPS, 1-4.30pm on designated Fridays, [Sept 27, Oct 11/25, Nov 8/15/29, Dec 13]
Session 2 : OLS, 1-4.30pm on designated Fridays, [Sept 13/20, Oct 18, Nov 1/22, Dec 6/20]
Parents/Legal Guardian Name(s):
*
Your answer
Phone Number (daytime):
*
Your answer
Alternative/Emergency Phone Number:
*
Your answer
Street Address:
*
Your answer
City/Town:
*
Your answer
Postal Code:
*
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?
*
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 38 Ridge Rd, Canmore, AB T1W 1G6
Please indicate your method of payment.
*
FEES: Session 1 : CRPS [7 sessions x $35/day = $245] Session 2 : OLS [7 sessions x $35/day = $245]
Choose
Email Transfer (send email to paleoplaycanmore@gmail.com)
Cheque (Payable to Corey Stevens, 38 Ridge Road, Canmore, AB, T1W 1G6)
A copy of your responses will be emailed to the address you provided.
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