Summer 2018 Integrated Playgroup (8 weeks)
Email address *
Parent Last Name *
Your answer
Parent First Name *
Your answer
Home Address (Street, Town, Zip) *
Your answer
Best Phone # *
Your answer
Total # of children in your family under 8 *
Your answer
Name of child #1 registering for program *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Name of child #2 registering for program
Your answer
Date of Birth
MM
/
DD
/
YYYY
Parent or caregiver who will bring child(ren) to the programs.
Your answer
Registration will be by lottery. Completing this form does not guarantee a space in the program.
All families requesting the Integrated Playgroup will be called July 5-6 with lottery results.
Child #1
Child #2
Integrated Playgroup 7/12-8/30 for 18-30 mos.
How did you learn about FRN or these programs?
A copy of your responses will be emailed to the address you provided.
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