"Building Blocks of Gross Motor Play" Registration Form
Thank you for your interest in our group program! Please fill out this form to begin the registration process. 
This program will run March 27th, 2023 - March 31st, 2023, from 10:00am - 11:00am.
It is open for children ages 3 -5 of all ability levels. 
We will be running the program at FUNctional Place, 28 Mission Ave, St. Albert. 
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Email *
General Information:
Child's first name: *
Child's last name: *
Age: *
Name of parent/guardian child resides with:
Preferred phone number to be reached at:
Emergency contact name and number (if different than parent information):
Will you as a parent/guardian be attending or having your hired support person attend as an additional aid for your child? (Staff will be available for support as needed) *
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